Obtention of viable cell suspensions from breast cancer tumor biopsies for 3D chromatin conformation and single-cell transcriptome analysis.

Molecular and cellular characterization of tumors is essential due to the complex and heterogeneous nature of cancer. In recent decades, many bioinformatic tools and experimental techniques have been developed to achieve personalized characterization of tumors. However, sample handling continues to be a major challenge as limitations such as prior treatments before sample acquisition, the amount of tissue obtained, transportation, or the inability to process fresh samples pose a hurdle for experimental strategies that require viable cell suspensions. Here, we present an optimized protocol that allows the recovery of highly viable cell suspensions from breast cancer primary tumor biopsies. Using these cell suspensions we have successfully characterized genome architecture through Hi-C. Also, we have evaluated single-cell gene expression and the tumor cellular microenvironment through single-cell RNAseq. Both technologies are key in the detailed and personalized molecular characterization of tumor samples. The protocol described here is a cost-effective alternative to obtain viable cell suspensions from biopsies simply and efficiently.

Complicaciones maternas y perinatales en gestantes con lupus: Estudio de casos y controles / Maternal and Perinatal Complications in Pregnant Women with Lupus: Case control Study

Objetivo: Determinar la frecuencia de complicaciones materno-perinatales y factores clínicos asociados a estos resultados en estantes con lupus. Métodos: Se realizó un estudio de casos y controles a partir de historias clínicas de pacientes con diagnóstico Lupus Eritematoso Sistémico en embarazo, entre 2010-2022 en una institución de salud en Medellín-Colombia. Éstas se clasificaron como casos (pacientes con resultados adversos materno-perinatales) y controles (pacientes sin resultados adversos). Resultados: Se incluyó un total de 67 pacientes (35 casos y 32 controles). Las complicaciones maternas más frecuentes fueron los trastornos hipertensivos asociados al embarazo (71,4 %), incluyendo preeclampsia y una presentación importante de partos pretérmino (68,6 %). La nefritis lúpica previa y durante el embarazo, fue más frecuente en los casos que en los controles (31,4 % versus 9,4 %). Los compromisos cardiovasculares, de mucosas y musculo-esquelético, fueron más frecuentes durante el embarazo (31,4 %, 40 % y 34,3 %, respectivamente), coincidiendo con mayor actividad del lupus, principalmente durante el embarazo. El compromiso cardiovascular y de mucosas durante el embarazo, así como tener síndrome antifosfolípido se relacionaron con desenlace materno-perinatal adverso. Conclusión: Componentes clínicos propios de la enfermedad como la nefritis lúpica, el síndrome antifosfolípido, el compromiso cardiovascular, y de mucosas podrían predisponer a desenlaces maternos y/o perinatales adversos como trastornos hipertensivos asociados al embarazo, pretérmino, restricción de crecimiento fetal, entre otros(AU)

Objective: To determine the frequency of maternal-perinatal complications and the clinical factors associated with these outcomes in pregnant women with lupus. Methods: A case-control study was conducted using the medical records of patients diagnosed with pregnancy and lupus in a healthcare institution in Medellin, Colombia, between 2010 and 2022. The patients were classified as cases (patients with adverse maternal-perinatal outcomes) and controls (patients without adverse outcomes). Results: A total of 67 patients (35 cases and 32 controls) were included. The most frequent maternal complications were pregnancyassociated hypertensive disorders (71.4%), including preeclampsia and a significant presentation of preterm deliveries (68.6%). Lupus nephritis prior to and during pregnancy was more frequent in cases than in controls (31.4% versus 9.4%). Cardiovascular, mucosal and musculoskeletal compromises were more frequent during pregnancy (31.4%, 40% and 34.3%, respectively), coinciding with greater lupus activity, mainly during pregnancy. Cardiovascular and mucosal involvement during pregnancy, as well as having antiphospholipid syndrome, were related to adverse maternal-perinatal outcome. Conclusion: Clinical components of the disease such as lupus nephritis, antiphospholipid syndrome, cardiovascular and mucosal involvement, are factors that may predispose these patients to adverse maternal and/or perinatal outcomes, such as hypertensive disorders associated with pregnancy, low birth weight, preterm, fetal growth restriction, among others(AU)

[Neuropsychological profile of Mexican paediatric patients with pharmacoresistant focal epilepsy]. / Perfil neuropsicológico de pacientes pediátricos mexicanos con epilepsia focal farmacorresistente.

INTRODUCTION: At least 20% of paediatric patients with epilepsy present resistance to multiple anti-crisis drugs in trials, which has a negative impact on their neuropsychological state, quality of life and prognosis; it is therefore necessary to document their neuropsychological profile in order to improve the clinical approach to them. AIMS: To describe the neuropsychological profile (cognitive, academic, behavioural, emotional, adaptive, sleep disturbances and quality of life) of paediatric patients with drug-resistant focal epilepsy in the frontal, temporal and occipital lobes, and to compare performance between patients with frontal and temporal foci, and to assess the link between the duration of the condition, the frequency of seizures and the amount of anti-crisis drugs and the neuropsychological profile. PATIENTS AND METHODS: The neuropsychological profile of 19 paediatric patients with a diagnosis of pharmacoresistant epilepsy with a mean age of 10.89 years was evaluated. RESULTS: 57.9% of the 19 patients were men. 63.2% presented frontal focus; 26.3% presented temporal focus; and 10.5% presented occipital focus. Deficiencies in attention, comprehension, verbal memory, working memory and processing speed, in addition to adaptive difficulties were observed. When the patients with frontal and temporal focus were compared, the former were found to present greater deficits in planning, while the patients with temporal focus presented more severe symptoms of anxiety. Patients with a longer disease duration were found to present greater impairment to their intelligence quotient and adaptive behavioural skills. CONCLUSIONS: Pharmacoresistant epilepsy in paediatric patients affects intelligence quotient and adaptive skills, as well as attention, memory and executive functions, and neuropsychological intervention programmes must therefore be implemented to improve these patients' quality of life.

TITLE: Perfil neuropsicológico de pacientes pediátricos mexicanos con epilepsia focal farmacorresistente.Introducción. Al menos el 20% de los pacientes pediátricos con epilepsia muestra resistencia a los ensayos de múltiples fármacos anticrisis, que impactan negativamente en su estado neuropsicológico, calidad de vida y pronóstico; por tal motivo, es necesario documentar ampliamente su perfil neuropsicológico para mejorar su abordaje clínico. Objetivos. Describir el perfil neuropsicológico (cognitivo, académico, conductual, emocional, adaptativo, alteraciones del sueño y calidad de vida) de pacientes pediátricos con epilepsia focal farmacorresistente de los lóbulos frontal, temporal y occipital, así como comparar el desempeño entre los pacientes con foco frontal y temporal, y evaluar la asociación entre la duración del padecimiento, la frecuencia de las crisis y la cantidad de fármacos anticrisis con el perfil neuropsicológico. Pacientes y métodos. Se evaluó el perfil neuropsicológico de 19 pacientes pediátricos con diagnóstico de epilepsia farmacorresistente, con una edad promedio de 10,89 años. Resultados. De los 19 pacientes, el 57,9% fueron hombres. El 63,2% presentó foco frontal; el 26,3%, temporal; y el 10,5%, occipital. Se encontraron deficiencias en atención, comprensión, memoria verbal, memoria de trabajo y velocidad de procesamiento, además de dificultades adaptativas. Al comparar a los pacientes con foco frontal y temporal, se encontró que los primeros presentaron mayores deficiencias en planificación, mientras que los pacientes con foco temporal presentaron mayores síntomas de ansiedad. Con respecto a la duración de la enfermedad, se encontró que los pacientes con mayor duración del padecimiento presentaron mayor afectación en el cociente intelectual y en las habilidades en la conducta adaptativa. Conclusiones. La epilepsia farmacorresistente en pacientes pediátricos afecta el cociente intelectual y las habilidades adaptativas, así como a la atención, la memoria y las funciones ejecutivas, por lo que es necesaria la implementación de programas de intervención neuropsicológica para mejorar la calidad de vida de estos pacientes.

Clinical and Surgical Outcomes of Endoscopic Endonasal Approach for Giant Pituitary Adenomas: Analysis of Predictive Factors.

BACKGROUND: Giant pituitary adenomas (GPAs) are defined as tumors with ≥40 mm in any maximum diameter, and these tend to invade multiple intracranial compartments. Hence, treatment remains a surgical challenge. OBJECTIVE: To describe the clinical and surgical outcomes of the endoscopic endonasal approach (EEA) for GPA in a pituitary referral center in Latin America and to analyze associated predictive factors. METHODS: 37 patients with histologically-confirmed GPA treated solely through the EEA between a 2-year period were included. Preoperative and postoperative clinical and neuroimaging findings; surgical morbidity and mortality; and binary logistic regression analysis to assess predictive factors were analyzed. RESULTS: Preoperative visual impairment prevalence was 97.3%. Mean tumor volume was 32 cc and gross total resection rate was 40.5%. Favorable visual acuity and visual fields outcome rate was 75% and 82.9%, respectively. In the multivariate analysis, bilateral cavernous sinus invasion (P = 0.018) and postoperative cerebrospinal fluid (CSF) leak (P = 0.036) were associated with an unfavorable visual acuity outcome, while radiation therapy (P = 0.035) was for visual fields. Similarly, intraoperative CSF leak was a predictive factor for postoperative CSF leak (10.8%) (P = 0.042) and vascular injury (13.5%) (P = 0.048). CONCLUSIONS: In this first Mexican clinical series, we demonstrated that the EEA is a safe and effective technique for GPA, although early diagnosis and prompt intervention may promote further visual function preservation without significant endocrine morbidity.

Polymorphisms of CCR5, IL-6, IFN-γ and IL-10 genes in Cuban HIV/AIDS patients.

INTRODUCTION: Genetic studies have shown associations of several single nucleotide polymorphisms (SNP) with different rates of progression and variation in susceptibility to HIV infection. This study aimed to estimate the frequency of ccr5Δ32, IL-6-174G/C, IFN-γ+874T/A and IL-10-1082A/G polymorphisms in Cuban HIV-infected patients and a group of sero-discordant couples to assess their influence on risk and disease progression. METHODS: A cross-sectional study was carried out on 120 subjects registered at the Institute of Tropical Medicine «Pedro Kour¼ (IPK) and the Ameijeiras Hospital from June 2018 until December 2019. The amplification of fragments of the ccr5, IL-6, IFN-γ and IL-10 genes was performed by polymerase chain reaction followed by identification of polymorphisms using the restriction fragment length polymorphism analysis for IL-6 with the restriction enzymes Nla III. Amplification Refractory Mutation System was used for IFN-γ and IL-10 genes. RESULTS: The allelic and genotypic distributions of the genes ccr5, IL-6, IFN-γ and IL-10 did not differ significantly between the two groups. Cell counts and plasma viral load values did not differ significantly between genotypes of the ccr5, IL-6, IFN-γ and IL-10 genes. Only the IL-6 GC genotype was associated with higher viral load values. The combination of alleles of the four considered SNPs showed a highly significant increase in the risk of HIV infection for one of them, but with a very low frequency (<1%). CONCLUSION: This study contributes to evaluating the frequency of these polymorphisms and their influence on biomarkers of the progression of HIV infection in the Cuban HIV-population.

Raman spectroscopy and molecular dynamics simulations of aqueous two-phase systems for the purification of phosphoric acid.

In this work, Raman spectroscopy and molecular dynamics simulations were used to elucidate key interactions between polyethylene glycol (PEG) and phosphoric acid (H3PO4) in aqueous two-phase systems for the extraction of phosphoric acid. Extensive molecular dynamics simulations were performed, and radial distribution functions as well as hydrogen bonds between PEG and other molecules were measured. Experimental data were used in combination with the slope method to infer PEG-H3PO4 interactions, and the interpretation is consistent with molecular simulation results. Based on our experimental and simulation results, we propose a solvation mechanism governed by hydrogen bonding interactions: at low concentrations of H3PO4 within the polymer-rich aqueous solution, entropy dominates and phosphoric acid molecules have weak interactions with PEG; as the concentration of phosphoric acid increases above a certain critical value, enthalpy dominates with PEG molecules interacting strongly with H3PO4 molecules via hydrogen bonds.

High-power ultrasound bleaching technique for canola oil (Brassica napus L.): Pigments removal and quality parameters.

Canola seeds (Brassica napus L.) are among the most commonly used seeds in Mexico for vegetable oil production. This is based on the high yield and content of polyunsaturated and monounsaturated fatty acids. During oil bleaching, it is important to maintain fatty acids in their cis configuration because of the health concerns associated with trans-fatty acid consumption. In this sense, the industrial processing parameters employed for this purpose present some limitations, such as high temperatures and long times, which may change the cis configuration to trans. In addition, the amount of bleaching clay employed for this process could be a source of contamination because it is disposed of after treatment. Therefore, the aim of this study was to develop a bleaching process for canola oil using high-power ultrasound (US). US processing was applied to nine treatments with different processing times (60, 75, and 90 min), clay percentages (1, 2, and 3%), and temperatures (60 and 80 °C) to determine the concentrations of chlorophyll a and b (µg chlo/100 g oil), carotenes (µg ß-carotene/100 g oil), color (L*, a*, b*, C*, and h°), iodine value (g I2/100 g oil), and finally carrying out a spectroscopic analysis (ATR-FTIR and Raman). A conventional bleaching treatment (100 °C for 180 min, 3% bleaching clay) was used as a control. The results revealed that US treatments with 2% clay at 60 °C for 60 and 90 min eliminated most of the chlorophyll compounds (98%). However, in terms of carotenes reduction, these identical treatments exhibited a similar tendency to that of the control (approximately 30% decrease). These findings also affected the sample color, in which US treatments revealed chromatic coordinates that indicated yellow tones with chroma values that were more intense than those in the control samples. In terms of the iodine value, such treatments fulfilled the international standards for vegetable oils (90-100 g I2/100 g oil). Finally, the spectroscopic study revealed no trans configurations or the presence of different chemical compounds after US treatment, because neither of them presented typical peaks for those molecular configurations. In this regard, US can be a useful methodology for bleaching vegetable oils, helping to reduce time, and bleaching clay with similar pigment reduction results.

Inferring interactions in multispecies communities: The cryptocurrency market case.

We introduce a general framework for empirically detecting interactions in communities of entities characterized by different features. This approach is inspired by ideas and methods coming from ecology and finance and is applied to a large dataset extracted from the cryptocurrency market. The inter-species interaction network is constructed using a similarity measure based on the log-growth rate of the capitalizations of the cryptocurrency market. The detected relevant interactions are only of the cooperative type, and the network presents a well-defined clustered structure, with two practically disjointed communities. The first one is made up of highly capitalized cryptocurrencies that are tightly connected, and the second one is made up of small-cap cryptocurrencies that are loosely linked. This approach based on the log-growth rate, instead of the conventional price returns, seems to enhance the discriminative potential of the network representation, highlighting a modular structure with compact communities and a rich hierarchy that can be ascribed to different functional groups. In fact, inside the community of the more capitalized coins, we can distinguish between clusters composed of some of the more popular first-generation cryptocurrencies, and clusters made up of second-generation cryptocurrencies. Alternatively, we construct the network of directed interactions by using the partial correlations of the log-growth rate. This network displays the important centrality of Bitcoin, discloses a core cluster containing a branch with the most capitalized first-generation cryptocurrencies, and emphasizes interesting correspondences between the detected direct pair interactions and specific features of the related currencies. As risk strongly depends on the interaction structure of the cryptocurrency system, these results can be useful for assisting in hedging risks. The inferred network topology suggests fewer probable widespread contagions. Moreover, as the riskier coins do not strongly interact with the others, it is more difficult that they can drive the market to more fragile states.

Medicinal plants from Mexico used in the treatment of scorpion sting.

Scorpion sting envenomation is a major public health in Mexico. Rural communities rarely have antivenoms in the health centers, therefore, the people commonly resort to using medicinal plants to treat the symptoms of envenoming caused by scorpion venom, but this knowledge has not yet been reported in detail. In this review, we carry out a review of the medicinal plants used in Mexico against scorpion stings. PubMed, Google, Science Direct, and the Digital Library of Mexican Traditional Medicine (DLMTM) were used to collect data. The results showed the use of at least 48 medicinal plants distributed in 26 families, where Fabaceae (14.6%), Lamiaceae (10.4%), and Asteraceae (10.4%) have the maximum representation. The application of leaves (32%) was preferred followed by roots (20%), stem (17.3%), flowers (16%), and bark (8%). In addition, the most common method of use to treat scorpion stings is decoction (32.5%). The oral and topical routes of administration have similar percentages of use. In vitro and in vivo studies of Aristolochia elegans, Bouvardia ternifolia, and Mimosa tenuiflora were found, which showed an antagonistic effect on the contraction of the ileum caused by the venom of C. limpidus, likewise, they increased the LD50 of said venom and even B. ternofila showed reduced albumin extravasation. The results of these studies demonstrate the promising use of medicinal plants for future pharmacological applications; nevertheless, validation, bioactive compound isolation and toxicity studies are necessary to support and improve therapeutics.

How the COVID-19 pandemic affects the moral reasoning of pediatric residents and the general population.

BACKGROUND: Kohlberg's theory of moral development asserts that people progress through different stages of moral reasoning as their cognitive abilities and social interactions mature. Individuals at the lowest stage of moral reasoning (preconventional stage) judge moral issues based on self-interest, those with a medium stage (conventional stage) judge them based on compliance with rules and norms, and those at the highest stage (postconventional stage) judge moral issues based on universal principles and shared ideals. Upon attaining adulthood, it can be considered that there is stability in the stage of individuals' moral development; however, the effect of a global population crisis such as the one experienced in March 2020, when the World Health Organization (WHO) declared the COVID-19 pandemic, is unknown. The purpose of this study was to evaluate the changes in the moral reasoning of pediatric residents before and after one year of the COVID-19 pandemic and compare them with a general population group. METHODS: This is a naturalistic quasi-experimental study conducted with two groups, one comprised 47 pediatric residents of a tertiary hospital converted into a COVID hospital during the pandemic and another group comprised 47 beneficiaries of a family clinic who were not health workers. The defining issues test (DIT) was applied to the 94 participants during March 2020, before the pandemic initiated in Mexico, and later during March 2021. To assess intragroup changes, the McNemar-Bowker and Wilcoxon tests were used. RESULTS: Pediatric residents showed higher baseline stages of moral reasoning: 53% in the postconventional group compared to the general population group (7%). In the preconventional group, 23% were residents and 64% belonged to the general population. In the second measurement, one year after the start of the pandemic, the group of residents had a significant decrease of 13 points in the P index, unlike the general population group in which a decrease of 3 points was observed. This decrease however, did not equalize baseline stages. Pediatric residents remained 10 points higher than the general population group. Moral reasoning stages were associated with age and educational stage. CONCLUSIONS: After a year of the COVID-19 pandemic, we found a decrease in the stage of moral reasoning development in pediatric residents of a hospital converted for the care of patients with COVID-19, while it remained stable in the general population group. Physicians showed higher stages of moral reasoning at baseline than the general population.

Macrovascular and microvascular type 2 diabetes complications are interrelated in a mouse model.

AIM: Evaluate the development of multiple complications, their interactions, and common mechanisms in the same individual with T2D. MATERIAL AND METHODS: 4-week-old male C57BL/6J mice were divided into: control (n = 6) and T2D (n = 6). T2D was induced through a high-carbohydrate-diet and low doses of streptozotocin. T2D was validated by metabolic parameters. Diabetic neuropathy was evaluated by mechanical and thermal sensitivity tests. We performed a histopathological analysis of the heart, kidney, liver, and parotid salivary glands and changes in bone microarchitecture by µCT. We calculated the relative risk (RR), odd ratios (OR) and Pearson correlation coefficients between the different complications and metabolic features. RESULTS: T2D mice have cardiomyopathy, neuropathy, nephropathy, liver steatosis and fibrosis, structural damage in parotid salivary glands, and bone porosity. RR analysis shows that all complications are interrelated by hyperglycaemia, insulin resistance, obesity, and systemic inflammation. CONCLUSIONS: T2D mice develop multiple complications simultaneously, which are related to each other, and this is associated with metabolic alterations. Our findings open up new approaches for the study and new therapeutic approaches of the pathophysiology of T2D and its complications.

The role of single nucleotide variant rs3819817 of the Histidine Ammonia-Lyase gene and 25-Hydroxyvitamin D on bone mineral density, adiposity markers, and skin pigmentation, in Mexican population.

PURPOSE: Vitamin D (VD) deficiency and osteoporosis have become a global public health problem. A variant in the Histidine Ammonia-Lyase (HAL) gene has been associated with VD levels and bone mineral density (BMD). However, whether this variant has an influence on VD levels and BMD in Mexican adults remain unclear. METHODS: This cross-sectional analysis included 1,905 adults participating in the Health Worker Cohort Study and 164 indigenous postmenopausal women from the Metabolic Analysis in an Indigenous Sample (MAIS) cohort. The rs3819817 variant was genotyped by TaqMan probe assay. Total 25 hydroxyvitamin D levels were measured by DiaSorin Liaison. BMD at the different sites was assessed through dual-energy X-ray absorptiometry. Linear and logistic regression models were performed to evaluate the associations of interest. RESULTS: The prevalence of VD deficiency was 41%, showing differences between sexes. Obesity and skin pigmentation were associated with lower levels of VD in males and females. rs3819817-T allele was associated with low levels of 25-hydroxyvitamin D, VD deficiency, and hip and femoral neck BMD values (g/cm2). We found two interactions with VD levels, one between adiposity and rs3819817-T allele (P = 0.017) and another between skin pigmentation and rs3819817-T allele (P = 0.019). In indigenous postmenopausal women, we observed higher VD levels in the southern region compared to the northern region (P < 0.001); however, we did not observe differences by genotype. CONCLUSION: Our findings confirm that the genetic variant rs3819817 has an essential function in VD levels and BMD and suggests a role in skin pigmentation in the Mexican population.

Research and development of green roofs and green walls in Mexico: A review.

The residential sector is one of the primary energy consumers and emitters of greenhouse gases. Given the environmental problem, one of the methods of mitigating electricity consumption and reducing the temperature in buildings is green infrastructure: green roofs and walls. This article presents a compilation of the studies carried out in México about green infrastructure; the energy, thermal and environmental benefits obtained were analyzed according to the vegetation, substrate, climate, and systems configuration. In addition, the development of policies, laws, regulations, and incentives in the field of green roofs in Mexico was also analyzed. The results indicate that using green infrastructure can help mitigate greenhouse gases since a green roof can reduce the indoor temperature up to 19.9 °C, save 28 % annually in electricity consumption and remove 80 % of rainwater pollutants. Finally, the results of this research can provide insight for researchers, legislators, and urban planners about the state in which Mexico is located, as well as help in decision-making.

[Medial Hoffa fracture: a case report]. / Fractura de Hoffa medial: reporte de un caso.

INTRODUCTION: knee femoral condyle coronal fractures or Hoffa fractures are among the rarest fractures of the pelvic limb, being even more rare those of the medial condyle. The success in the management of these patients lies in the timely diagnosis and the consequent anatomical reduction of the femoral articular surface. CLINICAL CASE: the objective of this article is to present a patient with right medial Hoffa fracture, registered as a single case in the archives of our hospital. The patient was referred to us on November 2011, with a 10-day course after suffering a fall from horse ridding, presenting a forced varus mechanism and direct contusion of the right knee. He shows an anteroposterior and lateral knee X-rays showing a subtle solution of continuity in the coronal plane of the base of the medial condyle, corroborated with magnetic resonance imaging and was also associated with a non-surgical partial injury of both menisci and the anterior cruciate ligament. Surgical intervention was performed on 27th/11/2011, through open reduction with a medial approach and internal fixation with 7.0 mm (x2) cannulated screws. The patient was discharged with early and continuous mobilization of the knee, deferring support and rehabilitation until the 6th week. He is currently a wandering patient, asymptomatic, with complete range of motion. Because respecting the extensor apparatus through a medial approach and the articular surface with cannulated screws, it was observed in consequence an adequate evolution of our patient, being able to return to his daily activities, even remount.

INTRODUCCIÓN: las fracturas del cóndilo femoral en el plano coronal o fracturas de Hoffa se encuentran entre las fracturas más raras del miembro pélvico, pero son aún más raras las del cóndilo medial. El éxito en el manejo de estos pacientes radica en el diagnóstico oportuno y la consecuente reducción anatómica de la superficie articular del fémur. CASO CLÍNICO: el objetivo de este reporte es presentar a un paciente con el diagnóstico de fractura de Hoffa medial derecha, registrado como caso único en los archivos de nuestro hospital. El paciente acudió referido en Noviembre de 2011, con evolución de 10 días tras sufrir caída de caballo, presentando mecanismo de varo forzado y contusión directa de la rodilla derecha. Mostró radiografías anteroposterior y lateral de rodilla derecha, donde se observó de forma sutil solución de la continuidad en el plano coronal de la base del cóndilo medial, corroborado por resonancia magnética y asociado a lesiones parciales no quirúrgicas de ambos meniscos y del ligamento cruzado anterior. Se intervino quirúrgicamente el día 27 de Noviembre de 2011 mediante reducción abierta con abordaje medial y fijación interna con dos tornillos canulados de 7.0 mm. Se egresó al paciente indicando la movilización temprana y continua de la rodilla, difiriendo el apoyo y rehabilitación hasta la sexta semana. Actualmente el paciente se encuentra con posibilidad de deambulación, asintomático y con arcos de movilidad completos. El respeto del aparato extensor mediante un abordaje medial y la superficie articular con tornillos canulados se refleja en la adecuada evolución de nuestro paciente, pudiendo regresar a sus actividades diarias, incluso el montar.

Matrix Metalloproteinases and Stress Hormones in Lung Cancer Progression.

Several matrix metalloproteinases (MMPs) and psychological stress are associated with poor cancer prognosis. The current work goal was to determine MMPs' and stress hormones' blood concentrations from lung adenocarcinoma (LAC) patients. Patients were divided into the following groups: tobacco smokers (TS), wood smoke-exposed (W), passive smokers (PS), TS exposed to wood smoke (TW), and patients with no recognizable risk factor (N). MMPs, tissue inhibitors of metalloproteinases (TIMPs), adrenaline, noradrenaline, and cortisol blood concentrations were measured by ELISA. Zymography and Western blot assays were performed to determine MMP-2 and MMP-9 active and latent forms. MMP-2, MMP-3, MMP-9, and TIMP-1 blood concentrations, and MMP-9 gelatinase activity were augmented, while MMP-12, MMP-14, and TIMP-2 were diminished in LAC patients. Cortisol was increased in LAC samples. Adrenaline concentrations were higher in W, TS, and TW, and noradrenaline was increased in W and N groups. Positive correlations were observed among cortisol and TIMP-1 (r s = 0.392) and TIMP-2 (r s = 0.409) in the W group and between noradrenaline and MMP-2 (r s = 0.391) in the N group. MMPs' blood concentration increments can be considered as lung cancer progression markers. Although stress hormones were also augmented, only weak correlations were observed between them and MMPs and TIMPs.

Frecuencia de diagnósticos de enfermería en pacientes hospitalizados con infección Covid-19 / Frequency of nursing diagnoses in hospitalized patients with covid-19 infection

Introducción: las respuestas humanas de la persona ante enfermedades nuevas como infecciones por coronavirus (COVID-19), deben estar plasmados en los diagnósticos de enfermería como parte de la utilización del pensamiento crítico al establecer un plan de cuidados. Objetivo: describir la frecuencia de los diagnósticos de enfermería reportados en expedientes de pacientes con infección por COVID-19.Material y métodos: investigación clínica, con enfoque cuantitativo, retrospectivo; muestra probabilística conformada por 163 expedientes de pacientes hospitalizados por diagnóstico COVID-19 del Hospital General de Tula, entre abril y octubre 2020. La información se recabó en una ficha de recolección de datos diseñada ex profeso, acorde a la hoja de enfermería del hospital, utilizando la taxonomía NANDA-I. Investigación aprobada por el Comité de ética e investigación. Resultados: n=163 expedientes, pacientes con infección COVID-19 edad entre 20 y 92 años, 58.9 % del género masculino; en el tratamiento establecido 97.5 % tuvo oxigenoterapia, el rango de estancia de 0-24 días de hospitalización. Los diagnósticos de enfermería registrados con mayor frecuencia fueron riesgo de aspiración (f=1095), ansiedad (f=1079), disconfort (f=928), fatiga (f=862), riesgo de shock (f=813), patrón respiratorio ineficaz (f=660) y limpieza ineficaz de las vías aéreas (f=606). Conclusiones: los diagnósticos de enfermería de la taxonomía NANDA-I son aplicables en pacientes con infección COVID-19, el más frecuente: riesgo de aspiración.

Introduction: the person's human responses to new diseases such as coronavirus infections (COVID-19), must be reflected in nursing diagnoses as part of the use of critical thinking when establishing a care plan. Objective: To describe the frequency of nursing diagnoses reported in the records of patients with COVID-19 infection. Material and methods: clinical research, with a quantitative, retrospective approach; the probabilistic sample was made up of 163 records of patients hospitalized for a COVID-19 diagnosis at the General Hospital of Tula, in the period April-October 2020. The information was collected in a data collection form designed expressly, according to the data sheet. Hospital nursing, using the NANDA-I taxonomy. Research approved by the Ethics and Research Committee. Results: n=163 records, the patients with COVID-19 infection were between 20-92 years old, 58.9% were male; in the established treatment, 97.5% had oxygen therapy, the range of stay was 0-24 days of hospitalization. The most frequently recorded nursing diagnoses were risk of aspiration (f=1095), anxiety (f=1079), discomfort (f=928), fatigue (f=862), risk of shock (f=813), respiratory pattern ineffective (f=660) and ineffective airway clearance (f=606). Conclusions: the nursing diagnoses of the NANDA-I taxonomy are applicable in patients with COVID-19 infection, the most frequent was: risk of aspiration

Risk factors associated with HCV co-infection amongst MSM and transgender women living with HIV in Mexico City: A case-control study.

INTRODUCTION AND OBJECTIVES: Hepatitis C virus infection (HCV) is a major cause of co-morbidity in people living with HIV (PLWHIV). The modes of HCV transmission in the local population of PLWHIV are still unclear. We conducted this study to identify risk factors for HCV transmission amongst PLWHIV in central Mexico. MATERIAL AND METHODS: We enrolled HIV/HCV co-infected cases and HIV controls receiving care in two outpatient clinics in Mexico City. Structured questionnaires were applied, covering demographics, history of percutaneous exposures, sexual behaviors, self-reported STD and recreational drug use. The statistical analysis for between-group comparisons were multivariate logistic regression models to assess the risk factors associated with HCV co-infection. We limited the final analysis to men who have sex with men (MSM) to avoid confounders potentially related to HCV acquisition in other populations. RESULTS: Three hundred and thirty-four MSM with HIV (175 with HCV co-infection and 159 without) were analysed. We did not identify percutaneous exposures as risk factors for HCV. Intravenous drug use (IVDU) occurred in two cases and one control case. Risk factors independently associated with acquiring HCV co-infection were: history of an ulcerative STD (aOR=2.65, 95%CI=1.44-4.88), a HCV positive partner (aOR=5.25, 95%CI=2.78-9.91), having practiced insertive fisting (aOR=2.62, 95%CI=1.01-6.90), and rectal administration of drugs during sex (aOR=2.46, 95%CI=1.25-4.84). CONCLUSIONS: Risky sexual behaviors and chemsex seem to be the main drivers of HIV/HCV co-infection amongst PLWHIV in Central Mexico. IVDU and percutaneous exposures have a minor role in the local HCV epidemic. These findings highlight the importance of testing for HCV in sexually active MSMs.

In-silico study of the adsorption of H2, CO and CO2 chemical species on (TiO2)n n=15-20 clusters: The (TiO2)19 case as candidate promising.

In order to obtain an adsorption tendency of H2, CO and CO2 molecules on (TiO2)n n = 15-20 clusters, DFT calculations were carried out to evaluate the interaction among these systems. The (TiO2)19 cluster emerges as the best candidate to storage these chemical species. Then, two adsorption sites were considered to attach these molecules onto (TiO2)19 cluster: through of surface formed by i) titanium and ii) oxygen atoms, respectively. The adsorption energy values are more favored for case 1 than the case 2, due to short distances between titanium atom and these chemical species. In this sense, the larger values of chemisorption are related to great decreasing of values of vibrational modes for gases isolated respect to those bonded to bare cluster. In general, the values of electronic gap do not suffer drastic changes, however the HOMO iso-surfaces are displayed in different way for both cases, and LUMO is located at center of cluster for the whole set of systems analyzed in this study. The electronic transference occurs from chemical species toward atoms at adsorption site, in all systems. These results reveal that this (TiO2)19 cluster is good candidate to storage or sense different kind of gases; thereby, this system can be used as a hydrogen storage device for energy green applications.

Differences in moral reasoning among medical graduates, graduates with other degrees, and nonprofessional adults.

BACKGROUND: Reasoning and moral action are necessary to resolve day-to-day moral conflicts, and there are certain professions where a greater moral character is expected, e.g., medicine. Thus, it is desirable that medical students develop skills in this field. Some studies have evaluated the level of moral reasoning among medical students; however, there are no comparative studies involving other types of populations. Therefore, the objective of this study was to compare the moral reasoning among medical graduates with that of a group of young graduates with other degrees and of a group of nonprofessional adults. METHODS: An exploratory cross-sectional study was conducted. Pediatric residents and pediatric subspecialty residents at a pediatric hospital were invited to participate, forming the group of "medical graduates". A group of young people from a social program and students with a master's degree in a science from the same pediatric hospital were also invited to participate, comprising the group of "graduates with other degrees". Finally, a group of beneficiaries of a family clinic was invited to participate, which we categorized as "nonprofessionals". To evaluate the differences in moral reasoning between these 3 groups, we applied the Defining Issues Test (DIT), a moral reasoning questionnaire designed by James Rest using Kohlberg's theory of moral development. RESULTS: The moral reasoning of 237 subjects-88 from the "medical graduates" group, 82 from the "graduates with other degrees" group and 67 from the "nonprofessionals" group- was evaluated. We found differences in the profiles of moral development of the groups. The profile of the "nonprofessionals" showed a very high predominance of subjects at the preconventional level, 70%, but only 4.5% at the postconventional level. Among the "medical graduates", we observed 37.5% at the preconventional level and 34% at the postconventional level (X2 p < 0.001); this group had the highest percentage in this category. This large difference could be because the differences in the ages and socioeducational levels of nonprofessionals are much wider than those among medical graduates. However, significant differences were also found when the profiles of medical graduates were compared with those of graduates with other degrees, since the latter demonstrated 56% at the preconventional level and 18% at the postconventional level (X2 test, p = 0.02). CONCLUSIONS: Significant differences were found in moral reasoning among the groups that we evaluated. Among the group of medical graduates, there was a higher percentage of subjects at the postconventional level than among the group of graduates with other degrees and a much higher percentage than among the group of nonprofessionals. Our conclusions give the first evidence that studying medicine seems to influence the development of moral reasoning in its students. Therefore, we consider it relevant to develop educational strategies where the student is involved in simulated but realistic decision-making situations, where there are moral dilemmas to resolve from their early years of training.