Successive tendon injury in an in vivo rat overload model induces early damage and acute healing responses.

Introduction: Tendinopathy is a degenerative condition resulting from tendons experiencing abnormal levels of multi-scale damage over time, impairing their ability to repair. However, the damage markers associated with the initiation of tendinopathy are poorly understood, as the disease is largely characterized by end-stage clinical phenotypes. Thus, this study aimed to evaluate the acute tendon responses to successive fatigue bouts of tendon overload using an in vivo passive ankle dorsiflexion system. Methods: Sprague Dawley female rats underwent fatigue overloading to their Achilles tendons for 1, 2, or 3 loading bouts, with two days of rest in between each bout. Mechanical, structural, and biological assays were performed on tendon samples to evaluate the innate acute healing response to overload injuries. Results: Here, we show that fatigue overloading significantly reduces in vivo functional and mechanical properties, with reductions in hysteresis, peak stress, and loading and unloading moduli. Multi-scale structural damage on cellular, fibril, and fiber levels demonstrated accumulated micro-damage that may have induced a reparative response to successive loading bouts. The acute healing response resulted in alterations in matrix turnover and early inflammatory upregulations associated with matrix remodeling and acute responses to injuries. Discussion: This work demonstrates accumulated damage and acute changes to the tendon healing response caused by successive bouts of in vivo fatigue overloads. These results provide the avenue for future investigations of long-term evaluations of tendon overload in the context of tendinopathy.

[Public conversation on vaccines during the covid-19 pandemic in Argentina, 2021-2022]. / Conversación pública sobre vacunas en la pandemia de covid-19 en Argentina, 2021-2022.

In the face of declining vaccination coverage and the dissemination of health-related information, conversations in the public/mediatic digital sphere constitute a relevant study area for the field of health communication. Through a qualitative study based on the analysis of government publications, digital press, and social media, we characterize the public conversation on vaccines - in terms of topics, moments, axes, and framings in Argentina during the 2020-2021 period - marked by the debate on covid-19 vaccines. The results show that public conversation focused on covid-19 vaccination, structured in two distinct moments (vaccine production and vaccination campaign), and under moral framings grounded in vaccination as a care practice and science as an authoritative voice. Simultaneously, doubts about the safety and efficacy of vaccines shaped arguments of vaccine hesitancy, which we understand as part of extended practices associated with distrust towards institutions and reinterpretations of scientific knowledge and care.

Ante la caída de las coberturas vacunales y la circulación informativa sobre salud, las conversaciones en el entorno público/mediático digital constituyen un ámbito de estudio relevante para el campo de la comunicación en salud. A través de un estudio cualitativo, basado en el análisis de publicaciones del gobierno, la prensa digital y las redes sociales, caracterizamos la conversación pública sobre vacunas ­en términos de temas, momentos, ejes y encuadres en Argentina en el período 2020-2021­ signada por el debate sobre las vacunas covid-19. Los resultados muestran que la conversación pública se centralizó en la vacunación contra el covid-19, se estructuró en dos momentos diferenciados (producción de vacunas y campaña de vacunación) y bajo encuadres morales sustentados en la vacunación como práctica de cuidado y la ciencia como voz autorizada. En simultáneo, las dudas sobre la seguridad y eficacia de las vacunas estructuraron argumentos de reticencia vacunal, que entendemos como parte de prácticas extendidas, asociadas con las desconfianzas hacia las instituciones y reinterpretaciones del conocimiento científico y del cuidado.

Analysis of New Colposcopy Techniques in the Diagnosis and Evolution of SIL/CIN: Comparison of Colposcopy with the DSI System (COLPO-DSI Study).

Compared with conventional colposcopy, colposcopy assisted by DSI-map increases the detection of HSIL/CIN2+ and might help to identify the lesions more likely to regress. INTRODUCTION: Comparison of the performance of colposcopy assisted by dynamic spectral imaging (C-DSI) with that of conventional colposcopy (CC) in the diagnosis of cervical intraepithelial neoplasia (HSIL/CIN2 or CIN3). MATERIALS AND METHODS: A total of 1655 women were referred for colposcopy between 2012 and 2020 and included in the study. Of that total, 973 were examined by the same colposcopist with C-DSI, and 682 with CC. Comparisons between CC and C-DSI were made by using the histological diagnosis performed with a punch biopsy or loop electrosurgical excision procedure (LEEP) as the gold standard. A follow-up study was conducted until 2021 to detect progression to HSIL/CIN2 at 6, 12 and 24 months after first examination. RESULTS: C-DSI provided higher sensitivity for the diagnosis of HSIL/CIN2 or CIN 3 than CC (sensitivity of 76.8% and 86.6% vs. 54.2% and 72.2%, respectively). In negative or ASCUS/LSIL Pap smear results, C-DSI showed higher sensitivity than CC (sensitivity of 66.7% and 61.5% vs. 21.4% and 33.3%, respectively). In contrast, these differences were not observed in high-grade Pap smears. The sensitivity of C-DSI in cases with HPV16/18 infection was stronger than that of CC (73.53% vs. 56.67%). The sensitivity of C-DSI to detect the progression to HSIL/CIN2+ during follow-up was 30, 17.6 and 35.7% at 6, 12 and 24 months, respectively. CONCLUSIONS: The present study shows that C-DSI in women referred for colposcopy increases the HSIL/CIN 2-3 detection rate compared to conventional colposcopy. Nevertheless, C-DSI does not seem to be an important tool to predict the evolution of the lesions during follow-up.

Assessment of pH Value and Release of Calcium Ions in Calcium Silicate Cements: An In Vitro Comparative Study.

The goal of this study was to evaluate the pH and the release of calcium from four calcium-silicate-based cements. METHODS: Four materials were tested (ProClinic MTA; Angelus MTA; ProRoot MTA; Biodentine). The palatal canal root of acrylic upper molars was filled with each cement. Afterwards, they were set in phosphate-buffered saline. Measurements were taken by atomic adsorption spectroscopy (AAS) at 3, 24, 72, 168, 336, 672, and 1008 h. The pH was measured at the same timepoints. Kruskal-Wallis tests were carried out in each period, as the Kolmogorov-Smirnov and Shapiro-Wilk tests showed no parametric results. RESULTS: Significant differences (p < 0.05) in calcium release were found at the 3-, 24-, and 72-hour evaluations. All of the analyzed groups presented a release of calcium ions up to 168 h, and the general tendency was to increase up to 672 h, with a maximum release of 25.45 mg/g in the ProRoot group. We could only observe significant differences (p < 0.05) in pH value over 168 h between the Biodentine (7.93) and Angelus MTA (7.31) groups. CONCLUSIONS: There were significant differences (p < 0.05) in calcium release. Nevertheless, no significant differences (p > 0.05) in the pH values were found at the studied timepoints, except for the values at 168 h.

Case Report: Hemophagocytic Lymphohistiocytosis Secondary to Plasmodium ovale wallikeri Infection.

We report the first known case of hemophagocytic lymphohistiocytosis (HLH) secondary to imported Plasmodium ovale wallikeri infection in a 58-year-old white woman. A delayed diagnosis of malaria and HLH was made after protracted fever and pancytopenia failed to respond adequately to antimalarial treatment, which required intravenous methylprednisolone and gamma-globulin therapy to resolve.

Unraveling the Mechanisms of Ch-SeNP Cytotoxicity against Cancer Cells: Insights from Targeted and Untargeted Metabolomics.

Although chitosan-stabilized selenium nanoparticles (Ch-SeNPs) have emerged as a promising chemical form of selenium for anticancer purposes, gathering more profound knowledge related to molecular dysfunctions contributes significantly to the promotion of their evolution as a chemotherapeutic drug. In this sense, metabolites are the end products in the flow of gene expression and, thus, the most sensitive to changes in the physiological state of a biological system. Therefore, metabolomics provides a functional readout of the biochemical activity and cell state. In the present study, we evaluated alterations in the metabolomes of HepG2 cells after the exposure to Ch-SeNPs to elucidate the biomolecular mechanisms involved in their therapeutic effect. A targeted metabolomic approach was conducted to evaluate the levels of four of the main energy-related metabolites (adenosine triphosphate (ATP); adenosine diphosphate (ADP); nicotinamide adenine dinucleotide (NAD+); and 1,4-dihydronicotinamide adenine dinucleotide (NADH)), revealing alterations as a result of exposure to Ch-SeNPs related to a shortage in the energy supply system in the cell. In addition, an untargeted metabolomic experiment was performed, which allowed for the study of alterations in the global metabolic profile as a consequence of Ch-SeNP exposure. The results indicate that the TCA cycle and glycolytic pathways were impaired, while alternative pathways such as glutaminolysis and cysteine metabolism were upregulated. Additionally, increased fructose levels suggested the induction of hypoxia-like conditions. These findings highlight the potential of Ch-SeNPs to disrupt cancer cell metabolism and provide insights into the mechanisms underlying their antitumor effects.

Relación de triglicéridos y estimación de riesgocardiovasculares en mujeres posmenopáusicas / Triglyceride ratio and cardiovascular risk estimation inpostmenopausal women

Objetivo: Determinar la relación de triglicéridos basales, con el riesgo a desarrollar enfermedades cardiovasculares en mujeres posmenopáusicas. Método: Estudio descriptivo, observacional y transversal, donde a 31 pacientes posmenopáusicas y sin antecedentes de enfermedades cardiometabólicas, se les determinó parámetros antropométricos (peso, talla, índice de masa corporal -IMC-); perfil lipídico en ayunas (colesterol total, triglicéridos o TG, lipoproteínas de baja y alta densidad -LDL, HDL-), por método enzimático colorimétrico, apolipoproteína B 100 (Apo B-100) por inmunodifusión radial, índices matemáticos LDL/Apo B-100y TG/HDL y cálculo de colesterol no-HDL. Resultados: los promedio y desviación de las variables fueron: edad:59±5 años con tiempo de posmenopausia: 8,77±3,92 años; IMC:27,6±4,4 kg/m.; colesterol total: 194±36 mg/dl; triglicéridos: 85±35 mg/dl; HDL: 33±8 mg/dl; LDL: 144±33 mg/dl; no-HDL: 159±37 mg/dl; Apo B-100: 172±246 mg/dl; LDL/Apo B-100: 1,15±0,03 y TG/HDL: 4,46±1,28. Discusión: Las pacientes se encontraron con sobrepeso, triglicéridos normales, colesterol total y LDL aumentado y las HDL bajas. El LDL-C/Apo B-100-100, que se relaciona con el tamaño y densidad de LDL, estuvo por debajo de 1,3 indicando la presencia de partículas pequeñas-densas, mientras TG/HDL, que se usa para estimar riesgo cardiovascular, estuvo por encima del corte establecido de 3,5. Conclusiones: Al relacionar los triglicéridos basales con LDL/Apo B-100 y TG/HDL, se observa que a partir del valor de triglicéridos de 100 mg/dl, se observa la presencia de partículas de lipoproteínas pequeñas-densas, y un alto riesgo cardiovascular, por lo que es necesario en mujeres posmenopáusicas el seguimiento a partir del valor de triglicéridos en 100 mg/dL ya que pudiera implicar el desarrollo de enfermedades cardiovasculares, en esta población(AU)

Objective: To determine the relationship of basal triglycerides with the risk of developing cardiovascular disease in postmenopausal women. Method: Descriptive, observational and cross-sectional study, where 31 postmenopause patients with no history of cardiometabolic disease were determined anthropometric parameters (weight, height, BMI); fasting lipid profile (total cholesterol, triglycerides or TG, LDL,HDL, by colorimetric enzymatic method), Apo B-100 (byradial immunodiffusion), LDL/Apo B-100 and TG/HDL mathematical indices and calculation of non-HDL cholesterol. Results: the mean and deviation of the variables were: age:59±5 years with postmenopause time: 8.77±3.92 years; BMI:27.6±4.4 kg/m2; total cholesterol: 194±36 mg/dl; triglycerides:85±35 mg/dl; HDL: 33±8 mg/dl; LDL: 144±33 mg/dl; non-HDL: 159±37 mg/dl; Apo B-100: 172±246 mg/dl; LDL/Apo B-100: 1.15±0.03 and TG/HDL: 4.46±1.28. Discussion: Patients were found to be overweight, normal triglycerides, total and LDL cholesterol high, and low HDL. LDL-C/ApoB-100-100, which is related to LDL size and density, was below 1.3 indicating the presence of small-dense particles, while TG/HDL, which is used to estimate cardiovascular risk, was above the established cut-off of 3.5. Conclusions: When relating the basal triglycerides with LDL/Apo B-100 and TG/HDL, it is observed that from the triglyceride value of 100mg/dl, the presence of small-dense lipoprotein particuals anda high cardiovascular risk is observed, so it is necessary in postmenopausal women to follow up from the triglycerid evalue in 100 mg/dL since it could imply the development of cardiovascular diseases, in this population(AU)

[Tensions between social acceptance and individual reticence to COVID-19 vaccination: the perspective of fathers and mothers residing in the Autonomous City of Buenos Aires in the context of the COVID-19 pandemic]. / Tensiones entre la aceptación social y la reticencia individual a la vacunación: la perspectiva de padres y madres que residen en la Ciudad Autónoma de Buenos Aires en contexto de pandemia por COVID-19.

The decline in vaccination coverage associated with the population's mistrust of vaccines has been defined as a global health threat. Adopting a qualitative approach centered on the social significance of vaccines, we conducted semi-structured interviews with mothers and fathers in the City of Buenos Aires between July and December 2020. We describe and analyze their knowledge and the arguments used to justify their acceptance or reluctance to vaccinate their children in the context of COVID-19. The results show that the studied population possesses knowledge about vaccines and accepts them as a preventive practice. Nonetheless, it was possible to identify a broad spectrum of attitudes towards vaccination, including more reticent positions based on concerns regarding their safety, adverse effects, and the need to apply them for eradicated diseases, proposing vaccination as an optional and complementary practice to other care practices. Arguments are organized under the assumption of individual and moral responsibility for health care, an expression of the current sociocultural and health backdrop.

La caída en las coberturas de vacunación asociada a la desconfianza de la población hacia las vacunas ha sido definida como una amenaza para la salud a nivel global. A través de un enfoque cualitativo centrado en la significación social de las vacunas, se realizaron entrevistas semiestructuradas a madres y padres de la Ciudad Autónoma de Buenos Aires, entre julio y diciembre de 2020. Describimos y analizamos sus conocimientos y los argumentos esgrimidos para justificar su aceptación o reticencia a la vacunación de sus hijas e hijos en el contexto del COVID-19. Los resultados muestran que la población estudiada maneja conocimientos sobre las vacunas y las acepta como práctica preventiva. A su vez, reconstruimos un amplio espectro en el que identificamos actitudes reticentes a la vacunación, basadas en dudas sobre su seguridad, efectos adversos y la necesidad de aplicarlas para enfermedades erradicadas, proponiendo la vacunación como práctica opcional y complementaria a otras prácticas de cuidado. Los argumentos se organizan bajo el supuesto de la responsabilidad individual y moral sobre el cuidado de la salud, expresión del actual escenario sociocultural y sanitario.

Tuberculosis en grandes conglomerados urbanos: sentidos y prácticas de abordaje de los equipos de una red de servicios públicos de la Ciudad de Buenos Aires, Argentina

Introducción: la tuberculosis (TB) persiste como un importante problema de salud pública en Argentina con una concentración preocupante en grandes centros urbanos. El objetivo de este estudio es la recuperación de los sentidos y las prácticas del proceso de atención-cuidado de la TB por parte de profesionales en una red pública de servicios de salud de un gran conglomerado urbano. Metodología: se realizó un análisis exploratorio con enfoque cualitativo, a partir de entrevistas semiestructuradas a integrantes de equipos sanitarios en un hospital y en centros de salud de la Ciudad Autónoma de Buenos Aires (CABA). Resultados: se identificaron diferentes matices de sentido acerca de la complejidad en el abordaje de la TB, estos variaban de acuerdo con las características de los servicios y las personas con TB. Se describieron estrategias para el tratamiento de casos difíciles: disponer de equipos interdisciplinarios, involucrar a otros actores de salud y dialogar con organizaciones de la sociedad civil bajo un enfoque territorial. Conclusiones: el control de la problemática de la TB en los grandes conglomerados urbanos presenta amplios desafíos. Desde la perspectiva del personal sanitario, se observan coyunturas que requieren la adecuación de ciertas estrategias interventoras para dar una respuesta de manera integrada.

Introduction: Tuberculosis (TB) persists as an important public health problem in Argentina with a worrying concentration in large urban centers. The objective of this study is to recover the meanings and practices of professionals from a public network of health services in a large urban conglomerate on the TB care-care process. Methods: An exploratory study with a qualitative approach was carried out, based on semi-structured interviews with members of the health teams of a hospital and health centers of the CABA. Results: It was identified that, from the perspective of the health teams, there are different nuances of meaning about the complexity of the TB approach. These varied according to the characteristics of the services in which they were inserted and of the people with TB. Strategies for dealing with complex cases were described: having interdisciplinary teams, acting together with other health effectors and dialoguing with civil society organizations under a territorial approach. Conclusion: The control of the TB problem in large urban conglomerates presents extensive challenges. From the perspective of health teams, complex situations are observed that require the development of certain strategies to address them. These allow the adaptation of interventions to provide an integrated response.

Melon/cowpea intercropping pattern influenced the N and C soil cycling and the abundance of soil rare bacterial taxa.

The high use of pesticides, herbicides, and unsustainable farming practices resulted in losses of soil quality. Sustainable farming practices such as intercropping could be a good alternative to traditional monocrop, especially using legumes such as cowpea (Vigna unguiculata L. Walp). In this study, different melon and cowpea intercropping patterns (melon mixed with cowpea in the same row (MC1); alternating one melon row and one cowpea row (MC2); alternating two melon rows and one cowpea row (MC3)) were assayed to study the intercropping effect on soil bacterial community through 16S rRNA region in a 3-year experiment. The results indicated that intercropping showed high content of total organic carbon, total nitrogen and ammonium, melon yield, and bacterial diversity as well as higher levels of beneficial soil microorganisms such a Pseudomonas, Aeromicrobium, Niastella, or Sphingomonas which can promote plant growth and plant defense against pathogens. Furthermore, intercropping showed a higher rare taxa diversity in two (MC1 and MC2) out of the three intercropping systems. In addition, N-cycling genes such as nirB, nosZ, and amoA were more abundant in MC1 and MC2 whereas the narG predicted gene was far more abundant in the intercropping systems than in the monocrop at the end of the 3-year experiment. This research fills a gap in knowledge about the importance of soil bacteria in an intercropping melon/cowpea pattern, showing the benefits to yield and soil quality with a decrease in N fertilization.

Misleading Advertising of Health-Related Products in Ecuador during the COVID-19 Pandemic.

Background Media coverage of the COVID-19 pandemic increased tuning ratings during this time. The aim of this study was to identify misleading advertising of health-related products on Ecuadorian television during the COVID-19 pandemic. Methods Television channels were monitored for 111 h in the months of June and October 2020. Verbal, nonverbal and context content were analyzed from each advertising spot according to ethical standards for the promotion of products for human health Results A total of 667 spots were analyzed. Most, 90%, involved misleading advertising of health-related products. Products for gastrointestinal conditions were the most publicized (17.8%) during the period analyzed. Newscasts most often advertised products intended to improve sexual potency (22.9%) and to a lesser degree those intended to prevent and treat respiratory problems (1.8%); this relationship was reversed when compared to general programming (p < 0.05). Conclusions Most of the health-related products advertised on Ecuadorian television are advertised misleadingly, with news programs having the highest number of such advertisements per hour of programming.

Changes in Quality of Sleep, Mood, and Other Neuropsychiatric Symptoms After Switching Dolutegravir/Lamivudine/Abacavir to Darunavir/Cobicistat/Emtricitabine/Tenofovir Alafenamide in a Randomized Study of People With Human Immunodeficiency Virus With Poor Sleep Quality: GESIDA 10418.

Background: Although switching antiretroviral therapy (ART) in people with human immunodeficiency virus experiencing insomnia due to dolutegravir-related neurotoxicity is well founded upon evidence, there is a lack of proof in regard to the outcome of stopping dolutegravir-based ART in people without insomnia but reporting poor sleep quality. Methods: This is a randomized, multicenter, open-label study to evaluate the reversibility of patient-reported sleep disturbances in patients on dolutegravir/lamivudine/abacavir without insomnia after switching to darunavir/cobicistat/emtricitabine/tenofovir alafenamide. The participants were randomized to switch ART at baseline or at week 4 and then completed 8 weeks of darunavir/cobicistat/emtricitabine/tenofovir alafenamide. Our primary objective was to compare changes in sleep quality between arms at week 4. Secondary objectives were to compare changes in mood and neuropsychiatric symptoms (NS) at week 4 and 4 and 8 weeks after switching to darunavir/cobicistat/emtricitabine/tenofovir alafenamide. The participants completed a survey, including the Pittsburgh Sleep Quality Index (PSQI), the Hospital Anxiety and Depression scale (HADS), and specific questions to explore NS, at each visit to assess those objectives. Results: We included 72 participants. The results show that study arms were similar at baseline; however, at week 4, PSQI scores remained unchanged with dolutegravir/lamivudine/abacavir, whereas patients improved significantly after switching to darunavir/cobicistat/emtricitabine/tenofovir alafenamide. Similar differences between arms were also observed in HADS and NS changes. At weeks 4 and 8 after all participants switched to darunavir/cobicistat/emtricitabine/tenofovir alafenamide, we have observed significant improvements in PSQI and HAD scores and in NS. Conclusions: In patients reporting subclinical sleep disturbances without insomnia, switching from dolutegravir/lamivudine/abacavir to darunavir/cobicistat/emtricitabine/tenofovir alafenamide was associated with better sleep quality and improvements in mood and NS.

Perennial alley cropping contributes to decrease soil CO2 and N2O emissions and increase soil carbon sequestration in a Mediterranean almond orchard.

The implementation of alley cropping in orchards can be a sustainable strategy to increase farm productivity by crop diversification and contribute to climate change mitigation. In this research, we evaluated the short-term effect of alley cropping with reduced tillage on soil CO2 and N2O emissions and soil total organic carbon (TOC) in an almond orchard under Mediterranean rainfed conditions. We compared an almond monoculture with tillage in all plot surface (MC) with almond crop with reduced tillage and growth of Capparis spinosa (D1) and almond crop with reduced tillage and growth of Thymus hyemalis (D2). For two years, soil CO2 and N2O were measured, with soil sampling at the start and end of the experimental period. Results showed that CO2 emission rates followed the soil temperature pattern, while N2O emissions were not correlated with temperature nor moisture. Soil CO2 emissions were significantly higher in MC (87 mg m-2 h-1), with no significant differences between D1 and D2 (69 mg m-2 h-1). Some peaks in CO2 effluxes were observed after tillage operations during warm days. Soil N2O emission rates were not significantly different among treatments. Cumulative CO2 and CO2 equivalent (CO2e) emissions were significantly highest in MC. When CO2e emissions were expressed on a crop production basis, D2 showed the significantly lowest values (5080 g kg-1) compared to D1 (50,419 g kg-1) and MC (87,836 g kg-1), owing to the high thyme yield, additional to the almond yield. No production was obtained for C. spinosa, since at least two more years are required. TOC did not change with time in MC neither D1, but it significantly increased in D2 from 3.85 g kg-1 in 2019 to 4.62 g kg-1 in 2021. Thus, alley cropping can contribute to increase the agroecosystem productivity and reduce CO2 emissions. However, it is necessary to grow evergreen alley crops such as thyme to obtain short-term increases in soil organic matter. Thus, to estimate increases in TOC with alley cropping, the plantation density and the period required by the crop to cover most of the surface are essential factors at planning the cropping strategy.

Beneficial Effect of Short-Term Supplementation of High Dose of Vitamin D3 in Hospitalized Patients With COVID-19: A Multicenter, Single-Blinded, Prospective Randomized Pilot Clinical Trial.

There is now sufficient evidence to support that vitamin D deficiency may predispose to SARS-CoV-2 infection and increase COVID-19 severity and mortality. It has been suggested that vitamin D3 supplementation may be used prophylactically as an affordable and safe strategy that could be added to the existing COVID-19 standard treatment. This multicenter, single-blinded, prospective randomized pilot clinical trial aimed to evaluate the safety, tolerability, and effectiveness of 10,000 IU/day in comparison with 2000 IU/day of cholecalciferol supplementation for 14 days to reduce the duration and severity of COVID-19 in 85 hospitalized individuals. The median age of the participants was 65 years (Interquartile range (IQR): 53-74), most of them (71%) were men and the mean baseline of 25-hydroxyvitamin D (25(OH)D) in serum was 15 ng/ml (standard deviation (SD):6). After 14 days of supplementation, serum 25(OH)D levels were significantly increased in the group who received 10,000IU/day (p < 0.0001) (n = 44) in comparison with the 2,000IU/day group (n = 41), especially in overweight and obese participants, and the higher dose was well tolerated. A fraction of the individuals in our cohort (10/85) developed acute respiratory distress syndrome (ARDS). The median length of hospital stay in these patients with ARDS was significantly different in the participants assigned to the 10,000IU/day group (n = 4; 7 days; IQR: 4-13) and the 2,000IU/day group (n = 6; 27 days; IQR: 12-45) (p = 0.04). Moreover, the inspired oxygen fraction was reduced 7.6-fold in the high dose group (p = 0.049). In terms of blood parameters, we did not identify overall significant improvements, although the platelet count showed a modest but significant difference in those patients who were supplemented with the higher dose (p = 0.0492). In conclusion, the administration of 10,000IU/day of vitamin D3 for 14 days in association with the standard clinical care during hospitalization for COVID-19 was safe, tolerable, and beneficial, thereby helping to improve the prognosis during the recovery process.

Mortality in patients with cancer and SARS-CoV-2 infection: Results from the Argentinean Network of Hospital-Based Cancer Registries.

BACKGROUND: Cancer is an important risk factor in patients with COVID-19. We aimed to describe the clinical and demographic characteristics associated with mortality in patients with cancer who were infected with SARS-CoV-2. METHODS: We conducted a retrospective longitudinal study of 1206 patients with confirmed SARS-CoV-2 infection and cancer, registered in the Argentinean Network of Hospital-Based Cancer Registries (RITA) from March 31, 2020 to January 31, 2021. Demographic and clinical differences between survivors and non-survivors were summarized using descriptive statistics. The primary endpoint was all-cause mortality within 30 days of COVID-19 diagnosis. Risk factors for mortality were identified using logistic regression models. RESULTS: 1206 patients with cancer and confirmed SARS-CoV-2 infection were included, median age was 54 years (interquartile range: 42-65); 793 (65.8%) were female. 1101 (91.3%) had solid tumors and 105(8.7%) had hematological malignancies. The most frequent solid tumor was breast (278, 23.1%), while lymphoma was the main hematological one (59, 4.9%). Cervical cancer was more frequent in survivors, while lung cancer predominated in non-survivors. 275 (22.8%) patients were diagnosed with cancer within the past year. A total of 129 (10.7%) patients died within 30 days after COVID-19 diagnosis, with a case fatality rate of 15.2% (16/105) for hematologic malignancies and 10.3% (113/1101) for solid tumors. Multivariable regression analysis showed that age 60-79 (odds ratio [OR]: 4.69, 95% confidence interval [CI]: 2.72-9.70), age ≥ 80 (OR: 12.86, 95%CI: 5.08-32.54), time since cancer diagnosis < 1 year (OR: 2.49, 95%CI: 1.57-3.93) and 1-2 years (OR: 2.20, 95%CI: 1.36-3.57), and lung cancer (OR: 4.35, 95%CI: 2.02-9.36) were risk factors for death. CONCLUSION: Patients with cancer and SARS-CoV-2 infection had a high case-fatality rate. Identified risk factors (older age, recent diagnosis and lung type) could guide prevention strategies aimed at reducing the risk of dying from COVID-19 in cancer patients.

A Multi-Omics Approach to Evaluate the Toxicity Mechanisms Associated with Silver Nanoparticles Exposure.

Silver nanoparticles (AgNPs) are currently used in many different industrial, commercial and health fields, mainly due to their antibacterial properties. Due to this widespread use, humans and the environment are increasingly exposed to these types of nanoparticles, which is the reason why the evaluation of the potential toxicity associated with AgNPs is of great importance. Although some of the toxic effects induced by AgNPs have already been shown, the elucidation of more complete mechanisms is yet to be achieved. In this sense, and since the integration of metabolomics and transcriptomics approaches constitutes a very useful strategy, in the present study targeted and untargeted metabolomics and DNA microarrays assays have been combined to evaluate the molecular mechanisms involved in the toxicity induced by 10 nm AgNPs. The results have shown that AgNPs induce the synthesis of glutathione as a cellular defense mechanism to face the oxidative environment, while inducing the depletion of relevant molecules implicated in the synthesis of important antioxidants. In addition, it has been observed that AgNPs completely impair the intracellular energetic metabolism, especially affecting the production of adenosine triphosphate (ATP) and disrupting the tricarboxylic acids cycle. It has been demonstrated that AgNPs exposure also affects the glycolysis pathway. The effect on such pathway differs depending on the step of the cycle, which a significant increase in the levels of glucose as way to counterbalance the depleted levels of ATP.

Influencia de los trastornos psiquiátricos y la terapia de sustitución con opiáceos en el tratamiento del virus de la hepatitis c con antivirales de acción directa en usuarios de drogas por vía parenteral / Influence of psychiatric disorders and opioid substitution therapy on hepatitis C treatment with direct-acting antivirals in people who inject drugs

Introducción: La efectividad del tratamiento del virus de la hepatitis C (VHC) parece ser menor en usuarios de drogas por vía parenteral (UDVP). Analizamos la influencia de diversos factores como los trastornos psiquiátricos y la terapia de sustitución con opiáceos (TSO) en el tratamiento con antivirales de acción directa (AAD) de este colectivo.Pacientes y métodos: Trescientos treinta y dos pacientes UDVP fueron tratados con AAD en 12 hospitales de España entre 2004 y 2020. Se catalogaron, si se disponía del dato, en consumidores recientes y pasados (según si el último consumo fue en los últimos 3 años) y se recogieron diversas variables, evaluándose la efectividad del tratamiento según la carga viral 12 semanas tras la finalización del tratamiento con el parámetro «respuesta viral sostenida» (RVS12).Resultados: El 23,4% eran consumidores recientes y el 27,7% estaban en TSO. El 41,5% presentaban algún diagnóstico de enfermedad psiquiátrica. La RVS12 fue del 84,04%, ascendiendo al 96,21% al excluir del análisis a los pacientes que perdieron el seguimiento (12,7%). La RVS12 fue significativamente inferior debido a un aumento de la pérdida de seguimiento en consumidores recientes, aquellos en TSO, los que habían estado en prisión los últimos 5 años y pacientes naïve, así como en el trastorno de ansiedad generalizada y consumidores de benzodiacepinas.Conclusiones: La efectividad del tratamiento del VHC con AAD en UDVP es similar a la población general si se consigue un adecuado seguimiento. Es importante realizar un seguimiento más estrecho en pacientes en TSO, consumidores recientes y aquellos con enfermedad psiquiátrica.(AU)

Introduction: The effectiveness of the hepatitis C virus (HCV) treatment seems to be lower in people who inject drugs (PWID). We analyze the influence of various factors as psychiatric disorders and opioid substitution therapy (OST) on the treatment with direct-acting antivirals (DAA) in this collective.Patients and methods: Three hundred thirty-two PWID patients were treated with DAA in 12 Spanish hospitals between 2004 and 2020. They were catalogued in recent and former consumers (if the last consumption was in the last 3 years) and several variables were included, evaluating the effectiveness of the treatment according to the viral load 12 weeks after the end of the treatment with the parameter «sustained viral response» (SVR12).Results: 23.4% were recent consumers and 27.7% were on OST. The 41.5% had any diagnosis of psychiatric disorder. SVR12 was 84.04%, ascending to 96.21% when excluded from the analyses the patients lost to follow-up (12.7%). SVR12 was lower due to an increase in the loss to follow-up in recent consumers and other factors like OST, being in prison the last 5 years, naïve patients, generalized anxiety disorder and benzodiazepine consumption.Conclusions: The effectiveness of the HCV treatment with DAA in PWID is similar than in general population in patients whit an appropriate follow-up. It is important to maintain a closer follow-up in patients on OST, recent consumers and those with psychiatric disorders.(AU)

Data sources for drug utilization research in Latin American countries-A cross-national study: DASDUR-LATAM study.

PURPOSE: Drug utilization research (DUR) contributes to inform policymaking and to strengthen health systems. The availability of data sources is the first step for conducting DUR. However, documents that systematize these data sources in Latin American (LatAm) countries are not known. We compiled the potential data sources for DUR in the LatAm region. METHODS: A network of DUR experts from nine LatAm countries was assembled and experts conducted: (i) a website search of the government, academic, and private health institutions; (ii) screening of eligible data sources, and (iii) liaising with national experts in pharmacoepidemiology (via an online survey). The data sources were characterized by accessibility, geographic granularity, setting, sector of the data, sources and type of the data. Descriptive analyses were performed. RESULTS: We identified 125 data sources for DUR in nine LatAm countries. Thirty-eight (30%) of them were publicly and conveniently available; 89 (71%) were accessible with limitations, and 18 (14%) were not accessible or lacked clear rules for data access. From the 125 data sources, 76 (61%) were from the public sector only; 46 (37%) were from pharmacy records; 43 (34%) came from ambulatory settings and; 85 (68%) gave access to individual patient-level data. CONCLUSIONS: Although multiple sources for DUR are available in LatAm countries, the accessibility is a major challenge. The procedures for accessing DUR data should be transparent, feasible, affordable, and protocol-driven. This inventory could permit a comparison of drug utilization between countries identifying potential medication-related problems that need further exploration.

Influence of psychiatric disorders and opioid substitution therapy on hepatitis C treatment with direct-acting antivirals in people who inject drugs. / Influencia de los trastornos psiquiátricos y la terapia de sustitución con opiáceos en el tratamiento del virus de la hepatitis c con antivirales de acción directa en usuarios de drogas por vía parenteral.

INTRODUCTION: The effectiveness of the hepatitis C virus (HCV) treatment seems to be lower in people who inject drugs (PWID). We analyze the influence of various factors as psychiatric disorders and opioid substitution therapy (OST) on the treatment with direct-acting antivirals (DAA) in this collective. PATIENTS AND METHODS: Three hundred thirty-two PWID patients were treated with DAA in 12 Spanish hospitals between 2004 and 2020. They were catalogued in recent and former consumers (if the last consumption was in the last 3 years) and several variables were included, evaluating the effectiveness of the treatment according to the viral load 12 weeks after the end of the treatment with the parameter «sustained viral response¼ (SVR12). RESULTS: 23.4% were recent consumers and 27.7% were on OST. The 41.5% had any diagnosis of psychiatric disorder. SVR12 was 84.04%, ascending to 96.21% when excluded from the analyses the patients lost to follow-up (12.7%). SVR12 was lower due to an increase in the loss to follow-up in recent consumers and other factors like OST, being in prison the last 5 years, naïve patients, generalized anxiety disorder and benzodiazepine consumption. CONCLUSIONS: The effectiveness of the HCV treatment with DAA in PWID is similar than in general population in patients whit an appropriate follow-up. It is important to maintain a closer follow-up in patients on OST, recent consumers and those with psychiatric disorders.

Tensiones entre la aceptación social y la reticencia individual a la vacunación: la perspectiva de padres y madres que residen en la Ciudad Autónoma de Buenos Aires en contexto de pandemia por COVID-19 / Tensions between social acceptance and individual reticence to COVID-19 vaccination: the perspective of fathers and mothers residing in the Autonomous City of Buenos Aires in the context of the COVID-19 pandemic

RESUMEN La caída en las coberturas de vacunación asociada a la desconfianza de la población hacia las vacunas ha sido definida como una amenaza para la salud a nivel global. A través de un enfoque cualitativo centrado en la significación social de las vacunas, se realizaron entrevistas semiestructuradas a madres y padres de la Ciudad Autónoma de Buenos Aires, entre julio y diciembre de 2020. Describimos y analizamos sus conocimientos y los argumentos esgrimidos para justificar su aceptación o reticencia a la vacunación de sus hijas e hijos en el contexto del COVID-19. Los resultados muestran que la población estudiada maneja conocimientos sobre las vacunas y las acepta como práctica preventiva. A su vez, reconstruimos un amplio espectro en el que identificamos actitudes reticentes a la vacunación, basadas en dudas sobre su seguridad, efectos adversos y la necesidad de aplicarlas para enfermedades erradicadas, proponiendo la vacunación como práctica opcional y complementaria a otras prácticas de cuidado. Los argumentos se organizan bajo el supuesto de la responsabilidad individual y moral sobre el cuidado de la salud, expresión del actual escenario sociocultural y sanitario.

ABSTRACT The decline in vaccination coverage associated with the population's mistrust of vaccines has been defined as a global health threat. Adopting a qualitative approach centered on the social significance of vaccines, we conducted semi-structured interviews with mothers and fathers in the City of Buenos Aires between July and December 2020. We describe and analyze their knowledge and the arguments used to justify their acceptance or reluctance to vaccinate their children in the context of COVID-19. The results show that the studied population possesses knowledge about vaccines and accepts them as a preventive practice. Nonetheless, it was possible to identify a broad spectrum of attitudes towards vaccination, including more reticent positions based on concerns regarding their safety, adverse effects, and the need to apply them for eradicated diseases, proposing vaccination as an optional and complementary practice to other care practices. Arguments are organized under the assumption of individual and moral responsibility for health care, an expression of the current sociocultural and health backdrop.