Genome-wide analysis reveals that the cytochrome P450 family 7 subfamily B member 1 gene is implicated in growth traits in Rasa Aragonesa ewes.

Sheep are very well adapted to changing environments and are able to produce and reproduce with low inputs in feed and water better than other domestic ruminants. Indeed, the ewe body condition score (BCS) and live weight (LW) play a significant role in productive and reproductive performance. This work conducts a genome-wide association study (GWAS) to detect genetic variants associated with growth traits in 225 adult ewes of the Rasa Aragonesa breed by using the genotypes from 50 k and HD Illumina Ovine BeadChip. These ewes were measured for LW, BCS and growth rate (GR) for 2 years, from January to September. Corrected phenotypes for BCS, LW and GR were estimated and used as input for the GWAS. Only one single nucleotide polymorphism (SNP) rs425509273 in chromosome 9 (OAR9), associated with the GR, overcame the genome-wise significance level. One, three and nine SNPs were associated at the chromosome-wise level (FDR 10%) for traits BCS, LW and GR, respectively. The cytochrome P450 family 7 subfamily B member 1 (CYP7B1) candidate gene, located 83 kb upstream from SNP rs425509273 in OAR9, was partially isolated and Sanger-sequenced. Fifteen polymorphisms comprising 12 SNPs, two indels and one polyC, were detected in promoter, exon 1, 3, 5, and intron 1-3 region. The SNP association analysis of the polymorphisms located close to the transcription start site (TSS) showed that a 22 bp insertion located at -58 nucleotides from the TSS (indel (-58)), a polyC (-25), and two A/G SNPs (SNP3 (-114) and SNP5 (-63)) were associated with the GR trait, whereas only the indel (-58) was associated with the BCS trait. The haplotype analysis confirmed these results. The functional characterisation of the polymorphisms at CYP7B1 gene in liver by real-time quantitative PCR analysis confirmed that the mutations in the promoter region affected CYP7B1 gene expression. Our results demonstrated the involvement of the CYP7B1 gene promoter on GR and BCS traits in Rasa Aragonesa. These findings suggest that variations in ovine CYP7B1 may serve as potential genetic markers to be used in breeding programmes to improve growth characteristics that could influence reproductive traits.

Implementation of pre-harvest techniques in emerging agroforestry systems to increase the yield of cocoa tree (Theobroma cacao L.).

Cocoa is one of the most important tropical fruits worldwide, its importance lies in its use in the food, cosmetic and pharmaceutical industries. Cocoa yield has been affected by different environmental, cultural and phytosanitary aspects. The emergence of new growing areas allows exploring the possibility of generating new economic and ecological systems that comply with current trends in organic farming. For them, pre-harvest practices such as pruning and soil fertilization are two necessary tools to control the productivity of cocoa agroecosystems. Therefore, the objective of this research was to analyses the implementation of pre-harvest techniques and the quality soil to increase the yield in a cocoa agroecosystem in an emerging zone in the Huasteca Potosina of Mexico. The work was carried out in an emerging zone in the cultivation of cocoa in three different zones delimited in 30 × 30 m. Thinning and pruning practices were carried out to keep the space clear and observe the influence on fruit yield. In addition, the quality of the soil was measured in terms of physical conditions and nutrient content. 25 kg/ha of nitrogen, 22 kg/ha of P2O5, 24 kg/ha of K2O and 4 kg/ha of magnesium were added following the recommendation of the fertilization laboratory. The physical properties of the pod were also analyzed, such as size, weight, number of grains and color. And some of the cocoa bean such as size, weight and hardness, all these parameters to measure the average yield of cocoa pods. The results show a clear influence of the soil quality and pre-harvest practices on the physical properties of the fruit and the total yield from 472.36 ± 52.01 to 520.06 ± 104.91 kg. However, other aspects are also modified, such as the increase in the size of the pod and the cocoa bean. Other aspects such as the color of the pod and the hardness of the grain do not present statistical difference. In conclusion, pre-harvest practices together with the application of fertilizers are factors that positively influence the yield of cocoa fruit. Some of the limitations of this research were the age of the plants and the local plant species.

Metabolic memory determines oviductal gene expression of underfed ewes during early gestation.

Our aim was to investigate the oviduct environment by studying oviduct gene expression after undernutrition in day-5 pregnant ewes with different initial (i) BCS, and its association with the number of embryos recovered. Thirty-six ewes were divided into 2 groups with different iBCS: iBCS ≥2.75 (n = 19; high, H) and iBCS ≤2.25 (n = 17; low, L), and were randomly assigned to two nutritional treatments for 20 days: 1.5 (control, C) or 0.5 (underfed, U) times the daily maintenance requirements. Thus, the final four groups were: high-iBCS control (HC, n = 9), high-iBCS underfed (HU, n = 10), low-iBCS control (LC, n = 9) and low-iBCS underfed (LU, n = 8). Samples of oviduct were collected and the expression of target genes was quantified using real-time PCR. While high-iBCS control ewes presented more ADIPOR1 mRNA than the high-iBCS underfed group (P < 0.05) and low-iBCS control ewes (P = 0.01), high-iBCS underfed group presented higher ADIPOR2 gene expression than low-iBCS underfed ewes (P < 0.01) evidencing a differential oviductal gene expression for these receptors. In high-iBCS ewes, control animals presented higher IGFBP2 gene expression than underfed ewes (P < 0.05), associated these results with a poor oviductal environment. High-iBCS underfed ewes presented higher IGFBP4 gene expression than high-iBCS control ewes (P < 0.05). Stepwise regression models, using various combinations of data on metabolic and reproductive hormones, and oviduct gene expression as independent variables, identified a set of variables that accounted for 75% of the variation in the number of embryos recovered. In conclusion, the oviductal gene expression depends on body reserves and nutritional treatment, and the effect is gene-specific.

Enfermedad Diverticular: análisis de defunciones según sexo, grupo etario y regiones en Chile

Objetivo: Describir las defunciones por enfermedad diverticular de intestino en el período 2016 - 2020 en Chile según sexo, grupo etario y región. Material y Método: Estudio descriptivo. Se describieron 406 defunciones por enfermedad diverticular según sexo, grupo etario y región entre los años 2016-2020, realizando un análisis estadístico con el software IBM SPSS Statistics ® que incluyó una Prueba Binomial para análisis de defunciones según "sexo" y la Prueba de Kruskal Wallis para el estudio de significancia entre las variables "sexo" y "grupo etario". Se utilizó un intérvalo de confianza del 99% (p < 0,01). Resultados: se obtuvo una tasa de mortalidad 0,46/100.000 habitantes para el período estudiado. El sexo femenino fue predominante con una relación cercana a 3:1 (p < 0,01). Las defunciones aumentaron con la edad y el grupo etario con mayor número de defunciones fue el de 80-89. Se demostró relación entre sexo y grupo etario (p < 0,01). Las regiones con mayor tasa de mortalidad observada fueron Magallanes, Valparaíso y Maule. Discusión: La tasa de mortalidad es similar a la reportada a nivel mundial. Las mujeres mueren en una proporción mayor que los hombres, tal como es descrito en otros estudios. La mayor tasa de mortalidad observada en algunas regiones del país se podría asociar a la elevada prevalencia de factores de riesgo para la enfermedad. Conclusión: Las defunciones por enfermedad diverticular disminuyeron desde el año 2018, se evidencia que las mujeres presentan un número significativamente mayor de defunciones que los hombres y que existieron diferencias por región.

Aim: To describe deaths from diverticular bowel disease in the period 2016-2020 in Chile according to sex, age group and region. Material and Method: Descriptive study. 406 deaths due to diverticular disease were described according to sex, age group and region between the years 2016-2020, performing a statistical analysis with the IBM SPSS Statistics ® software that included a Binomial Test for analysis of deaths according to "sex" and the Kruskal Wallis Test for the study of significance between the variables "sex" and "age group". A 99% confidence interval (p < 0.01) was used. Results: A mortality rate of 0.46/100,000 inhabitants was obtained for the period. The female sex was predominant in a ratio close to 3:1 (p < 0.01). Deaths increased with age and the age group with the higher number of deaths was 80-89. A relationship between sex and age group was demonstrated (p < 0.01). The regions with the highest observed mortality rate were Magallanes, Valparaíso and Maule. Discussion: The mortality rate is similar to that reported worldwide. Women die at a higher rate than men, as described in other studies. The higher mortality rate observed in some regions of the country could be associated with the high prevalence of risk factors for the disease. Conclusion: Deaths from diverticular disease decreased since 2018, in conjunction with showing that women present a significantly higher number of deaths than men and that there were differences by region.

Mucormicosis periostomal posoperatoria, a propósito de un caso / Mucormycosis periostomal: case report

Resumen Introducción: La mucormicosis en una enfermedad infrecuente y oportunista que afecta, principalmente, a pacientes inmunocomprometidos. Pocas veces se han reportado casos de afectación periostomal. Clínicamente puede ser confundida con otras patologías, pudiendo tener una evolución fulminante, por lo que un adecuado y pronto diagnóstico son necesarios para una instauración precoz del tratamiento. Caso Clínico: Se presenta el caso de una paciente de 62 años inmunocomprometida, que tras complicaciones quirúrgicas evoluciona con mucormicosis periostomal de la pared abdominal. A pesar de un tratamiento quirúrgico con múltiples resecciones de tejido asociado a antifúngico local y sistémico, la paciente fallece, concordante a la letalidad expresada en la literatura.

Introduction: Mucormycosis is a rare and opportunistic disease that mainly affects immunocompromised patients. Few cases of peristomal involvement have been reported. Clinically it can be confused with other pathologies and may have a fulminant evolution, so an adequate and prompt diagnosis is necessary for an early establishment of treatment. Clinical Case: We present the case of a 62-year-old immunocompromised patient who, after surgical complications, evolves with periostomal mucormycosis of the abdominal wall. Despite surgical treatment with multiple tissue resections, associated with local and systemic antifungal agents, the patient died, consistent with the lethality expressed in the literature.

A framework for mapping and monitoring human-ocean interactions in near real-time during COVID-19 and beyond.

The human response to the COVID-19 pandemic set in motion an unprecedented shift in human activity with unknown long-term effects. The impacts in marine systems are expected to be highly dynamic at local and global scales. However, in comparison to terrestrial ecosystems, we are not well-prepared to document these changes in marine and coastal environments. The problems are two-fold: 1) manual and siloed data collection and processing, and 2) reliance on marine professionals for observation and analysis. These problems are relevant beyond the pandemic and are a barrier to understanding rapidly evolving blue economies, the impacts of climate change, and the many other changes our modern-day oceans are undergoing. The "Our Ocean in COVID-19″ project, which aims to track human-ocean interactions throughout the pandemic, uses the new eOceans platform (eOceans.app) to overcome these barriers. Working at local scales, a global network of ocean scientists and citizen scientists are collaborating to monitor the ocean in near real-time. The purpose of this paper is to bring this project to the attention of the marine conservation community, researchers, and the public wanting to track changes in their area. As our team continues to grow, this project will provide important baselines and temporal patterns for ocean conservation, policy, and innovation as society transitions towards a new normal. It may also provide a proof-of-concept for real-time, collaborative ocean monitoring that breaks down silos between academia, government, and at-sea stakeholders to create a stronger and more democratic blue economy with communities more resilient to ocean and global change.

Body packing: tráfico de drogas y cirugía. Reporte de un caso / Body packing: drug traffic and surgery. Case report

Resumen Objetivo: Exponer el caso de un paciente con intoxicación aguda por cocaína en contexto de un body packing syndrome, considerando sus aspectos médico-quirúrgicos y legales. Materiales y Método: Se obtuvo la ficha clínica, con resguardo de anonimato, de un paciente que acude al servicio de urgencia (SU) y que es intervenido y evolucionando posteriormente en el Hospital el Pino de San Bernardo, Chile. Resultados: Paciente fue sometido a una gastrotomía, una enterotomía y una colotomía después de haber sido estabilizado por paro cardiorrespiratorio presentado en SU. Es trasladado a unidad de cuidados intensivos (UCI) donde evoluciona desfavorablemente. Discusión: El body packing syndrome es una entidad clínica infrecuente que, en la minoría de los casos, puede presentar complicaciones severas que requieren de un tratamiento médico-quirúrgico inmediato. Conclusión: Considerando que tanto el consumo como el tráfico de drogas se mantienen como un importante problema de salud pública y que sus consecuencias pueden ser devastadoras, es importante tener conocimiento sobre el tema.

Aim: To present the case of a patient with acute cocaine intoxication in the context of body packing syndrome, taking into consideration its medical-surgical and legal aspects. Materials and Method: A clinical record with anonymity protection was obtained, from a patient who was admitted to the emergency room and who was subsequently operated on and managed at Hospital El Pino in San Bernardo, Chile. Results: Patient underwent a gastrotomy, an enterotomy and a colotomy after being stabilized from a cardiorespiratory arrest in the emergency room. He was transferred to the Intensive Care Unit (ICU) where he evolved unfavorably. Discussion: Body packing is an infrequent clinical entity that, in a few cases, may develop severe complications that require immediate medical-surgical treatment, in addition to notification to authorities. Conclusion: Considering that both drug use and traffick remain as an important public health concern and that as its consequences may be devastating, it is important to have a knowledge on the subject.

Phosphate-Arsenic Interactions in Halophilic Microorganisms of the Microbial Mat from Laguna Tebenquiche: from the Microenvironment to the Genomes.

Arsenic (As) is a metalloid present in the earth's crust and widely distributed in the environment. Due to its high concentrations in the Andean valleys and its chemical similarity with phosphorus (P), its biological role in Andean Microbial Ecosystems (AMEs) has begun to be studied. The AMEs are home to extremophilic microbial communities that form microbial mats, evaporites, and microbialites inhabiting Andean lakes, puquios, or salt flats. In this work, we characterize the biological role of As and the effect of phosphate in AMEs from the Laguna Tebenquiche (Atacama Desert, Chile). Using micro X-ray fluorescence, the distribution of As in microbial mat samples was mapped. Taxonomic and inferred functional profiles were obtained from enriched cultures of microbial mats incubated under As stress and different phosphate conditions. Additionally, representative microorganisms highly resistant to As and able to grow under low phosphate concentration were isolated and studied physiologically. Finally, the genomes of the isolated Salicola sp. and Halorubrum sp. were sequenced to analyze genes related to both phosphate metabolism and As resistance. The results revealed As as a key component of the microbial mat ecosystem: (i) As was distributed across all sections of the microbial mat and represented a significant weight percentage of the mat (0.17 %) in comparison with P (0.40%); (ii) Low phosphate concentration drastically changed the microbial community in microbial mat samples incubated under high salinity and high As concentrations; (iii) Archaea and Bacteria isolated from the microbial mat were highly resistant to arsenate (up to 500 mM), even under low phosphate concentration; (iv) The genomes of the two isolates were predicted to contain key genes in As metabolism (aioAB and arsC/acr3) and the genes predicted to encode the phosphate-specific transport operon (pstSCAB-phoU) are next to the arsC gene, suggesting a functional relationship between these two elements.

Criterios histopatológicos para el diagnóstico de fibrosis pulmonar idiopática / Histopathological criteria for the diagnosis of idiopathic pulmonary fibrosis

En la última actualización de las Guías de Práctica Clínica de la ATS/ERS/JRS/ALAT de fibrosis pulmonar idiopática (FPI) se propone una nueva forma de clasificar los patrones histopatológicos en 4 tipos: definitivo de neumonía intersticial usual (NIU), probable NIU, indeterminado y alternativo a NIU. Una remodelación fibrótica heterogénea de la arquitectura normal del parénquima pulmonar, con cicatrización destructiva en forma de "panal de abejas", presencia de focos fibroblásticos y distribución predominantemente subpleural y paraseptal, con escaso infiltrado inflamatorio intersticial de tipo crónico, asociado a la ausencia de elementos sugerentes de causas secundarias como distribución bronquiolocéntrica, predominio de infiltrados intersticiales inflamatorios o granulomas mal formados, permite un diagnóstico certero de FPI en un escenario clínico-radiológico adecuado.

In the latest update of the ATS/ERS/JRS/ALAT Clinical Practice Guidelines for idiopathic pulmonary fibrosis (IPF), a new way of classifying histopathological patterns in 4 types is proposed: definitive usual interstitial pneumonia (UIP), probable UIP, indeterminate and alternative to UIP. A heterogeneous fibrotic remodeling of the normal architecture of the pulmonary parenchyma, with destructive scarring in the form of "honeycomb", presence of fibroblastic foci and predominantly subpleural and paraseptal distribution, with scarce chronic interstitial inflammatory infiltrate, associated with the absence of elements suggestive of secondary causes such as bronchiolocentric distribution, predominance of inflammatory interstitial infiltrates or poorly formed granulomas, allows an accurate diagnosis of IPF in an appropriate clinical-radiological scenario.

A propósito de un caso: cuerpos extraños en colon en un servicio de urgencias de un hospital comarcal / Presentation of a case: foreign body in colon in a regional hospital emergency department

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The Influence of Chelating Agent on the Structural and Magnetic Properties of CoFe2O4, Nanoparticles.

We have studied the influence of chelating agents (glycerin and sucrose) on the structural and magnetic properties of cobalt ferrite (CoFe2O4) nanoparticles synthesized via co-precipitation method. The Rietveld refinements from X-ray diffraction patterns confirm that all samples are single phase identified in a cubic crystalline system belonging to the space group Fd-3m. Besides, we have verified that the addition of chelating agents produces a decreasing in the particles average size from 14(2) to 5(1) nm. Magnetization measurements as a function of temperature show a decrease in the blocking temperature (T(B)) to sample obtained with addition of sucrose. A superparamagnetic behavior at room temperature was observed by magnetic measurements as function of field in the sample with 0.020 mol/L of sucrose. The results show that character chelating of sucrose reduces the coalescence effect and magnetic interaction in the CoFe2O4 nanoparticles. These results suggest that sucrose could be an alternative to control the structural and magnetic properties of other oxides nanoparticles.

Synthesis, phase composition, Mössbauer and magnetic characterization of iron oxide nanoparticles.

The present work describes the synthesis of iron oxide nanoparticles by thermal decomposition of Fe-precursors in argon and vacuum environments with control over particle size distribution, phase composition and the resulting magnetic properties. The Rietveld refinement analysis of X-ray diffraction data revealed the crystallinity as well the single-phase of γ-Fe2O3 nanoparticles prepared under vacuum, whereas the argon environment leads to the formation of multi-phase composition of γ-Fe2O3/Fe3O4 (90%) and wustite (10%). Synchrotron X-ray absorption near edge structure (XANES) indicates that the predominant phase in both samples is γ-Fe2O3, which is subsequently verified from the Mössbauer spectra. DC magnetic measurements indicate behavior typical of a superparamagnetic system validated by Mössbauer analysis. However, further investigation of ac susceptibility by typical Néel-Arrhenius and Vogel Fulcher magnetic models suggests an influence of interparticle interactions on the overall magnetic behavior of the system.

Modelo de instilación intra-traqueal de jugo gástrico en la rata: curso temporal de las alteraciones histológicas / Intra-tracheal instillation of gastric juice in the rat: time course of histological changes

Introduction: Aspiration of gastric content is associated with a wide range of clinical conditions (acute lung injury, severe interstitial pneumonia or bronchiolitis obliterans following lung transplantation). Objective: To study the course of histological alterations in a model of intra-tracheal instillation of gastric juice in rats. Methods: Anesthetized rats were euthanized at different times: 4, 12 and 24 hours and 4 and 7 days after intratacheal (IT) instillation of gastric juice. Animals that were not intervened served as controls. The right inferior lobe was studied (H-E) and a histological injury score was given according to a recently published score system. Results: Between 4-24 h an inflammatory-hemorragic pattern with bronchiol-centric distribution was characterized by a large proportion of neutrophils in both alveoli and interstitium, alveolarfluid accumulation, proteinaceous material andfew hyaline membranes. Between 4 and 7 days, mononuclear cells were more prevalent, the hemorrhagic component disappeared, the percentage of abnormal bronchioles was significantly reduced and there was organization of the alveolar infiltrate, with Masson bodies, granulomas and giant cells associated with gastric juice particles. Conclusions: In rats, IT instillation of gastric juice induces diffuse alveolar damage that evolves towards an early granulomatous interstitial pneumonia along with lax fibrous tissue. Knowledge of the temporary course of the pulmonary responses helps to the understanding of the consequences of the several clinical conditions that favor gastric content aspiration.

Introducción: La aspiración de contenido gástrico se asocia con diversas condiciones clínicas (daño pulmonar agudo, neumonía intersticial severa o bronquiolitis obliterante post-trasplante). Objetivo: Estudiar el curso de las alteraciones histológicas en un modelo de instilación intra-traqueal (IT)de jugo gástrico en ratas. Métodos: Ratas anestesiadas recibieron vía ITjugo gástrico de un pool obtenido previamente. Los animales fueron sacrificados a las: 4, 12 y 24 h y 4 y 7 días post-instilación. Animales sin intervención sirvieron como controles. El lóbulo inferior derecho fue estudiado (H-E) para la asignación de un puntaje de daño histológico de acuerdo a un sistema de puntuación recientemente publicado. Resultados: Entre 4-24 h se observó un patrón inflamatorio-hemorrágico de distribución bronquíolo-céntrica, con predominio de neutrófilos intersticiales y alveolares, edema, material proteináceo alveolar y escasas membranas hialinas. Entre los 4 y 7 días, se observó predominio mononuclear y desaparición del componente hemorrágico, se redujo significativamente el porcentaje de bronquíolos afectados y se observó organización del infiltrado inflamatorio, con cuerpos de Masson, granulomas y células gigantes asociadas a partículas del jugo gástrico. Conclusiones: En ratas, la instilación IT de jugo gástrico induce daño alveolar difuso que progresa hacia una neumonía intersticial granulo-matosa temprana con tejido fibroso laxo. El conocimiento del curso de la respuesta pulmonar en este modelo, contribuye a comprender las posibles consecuencias de las condiciones clínicas que favorecen la aspiración de contenido gástrico.

Tuning the surface anisotropy in Fe-doped NiO nanoparticles.

Ni(1-x)FexO nanoparticles have been obtained by the co-precipitation chemical route. X-ray diffraction analyses using Rietveld refinement have shown a slight decrease in the microstrain and mean particle size as a function of the Fe content. The zero-field-cooling (ZFC) and field-cooling (FC) magnetization curves show superparamagnetic behavior at high temperatures and a low temperature peak (at T = 11 K), which is enhanced with increasing Fe concentration. Unusual behavior of the coercive field in the low temperature region and an exchange bias behavior were also observed. A decrease in the Fe concentration induces an increase in the exchange bias field. We argue that these behaviors can be linked with the strengthening of surface anisotropy caused by the incorporation of Fe ions.

Spectral envelope and periodic component in classification trees for pathological voice diagnostic.

This work investigates the effectiveness of features from the spectral envelope such as the frequency and bandwidth of the first peak obtained from a 30(th) order Linear Predictive Coefficients (LPC) to identify pathological voices. Other spectral features are also investigated and tested to improve the recognition rate. The value of the Relative Power of the Periodic Component is combined with spectral features, to diagnose pathological voices. Healthy voices and five vocal folds pathologies are tested. Decision Tree classifiers are used to evaluate which features have pathological voice information. Based on those results a simple Decision Tree was implemented and 94% of all the subjects in the database are correctly diagnosed.

Diagnóstico diferencial de nódulos pulmonares cavitados: a propósito de un caso clínico / Differential diagnosis of cavitary pulmonary nodules: a propos of a clinical case

El diagnóstico diferencial de nódulos pulmonares cavitados constituye un gran desafo en el cual, la clínica, la imagenología y los exámenes de laboratorio permiten una orientación etiológica en cutro grandes grupos: infecciosa, neoplásica, reumatológica y miscelánea. Presentamos el caso de una paciente gran fumadora y portadora de una diabetes mellitus descompensada, con nódulos pulmonares cavitados, en la cual el contexto clínico obligaba a plantear ciertas etiologías como las infecciosas y neoplásicas, pero cuya biopsia fue compatible con Granulomatosis con Poliangeítis (ex Granulomatosis de Wegener), sin una clínica ni exámenes de laboratorio concordantes con dicho hallazgo.

The differential diagnosis of cavitary pulmonary nodules is a great challenge, where the clinical context in addition to the image studies and laboratory tests are part of the key tools to guide the diagnostic process through 4 major etiological groups: infectious, neoplastic, rheumatologic and miscellaneous. We describe a case of a heavy smoker and complicated diabetic patient with cavitary pulmonary nodules, with a clinical context that induces certain etiologies such as infectious and neoplastic, but whose biopsy was compatible with Granulomatosis with polyangiitis (ex Wegener 's granulomatosis), without a clinical exam nor laboratory tests suggesting this finding.

Afasia y depresión post-ictus: una relación predictiva / Aphasia and post-stroke depression: a prediction relation

Introducción/objetivos. La depresión se ha mostrado como la complicación psiquiátrica post-ictus más común, y la que se asocia con un pronóstico peor. Todavía existe incerteza en cuanto a su etiología y factores de riesgo. Algunos factores son reconocidos: gravedad del ictus, grado de discapacidad y déficit cognitivo. Por ello, es urgente definir nuevos factores que faciliten un diagnóstico temprano, lo cual puede disminuir los efectos negativos sobre el proceso de rehabilitación. Objetivos. Determinar la incidencia de la depresión post-ictus (DPI) y estudiar las variables descritas en la literatura como posibles factores predictores de la DPI: sexo, edad, tipo de ictus, lateralidad, territorio vascular y presencia de afasia. Material y métodos. Estudio longitudinal retrospectivo incluyendo a todos los pacientes admitidos en una planta de Medicina Física y Rehabilitación con el diagnóstico de ictus de novo durante dos años. Inicialmente se incluyeron 144 pacientes. Los criterios de exclusión fueron «ictus previo», «enfermedad psiquiátrica previa con alteración del humor» y «medicación antidepresiva en el momento del ictus». La n final fue de 111 pacientes. Resultados. La incidencia de DPI fue de 38,7%. La presencia de afasia se mostró asociada significativamente con la depresión (p=0,05). No hubo relación con el tipo de afasia. Los otros predictores analizados no mostraron correlación estadísticamente significativa. Conclusiones. Este estudio establece la afasia como un factor predictivo de DPI. La elevada incidencia de la DPI en esta población concuerda con los estudios existentes. Adicionalmente se necesitan más estudios, no solo para aumentar el conocimiento de los factores de riesgo para la DPI, sino también para mejorar los resultados de los programas de rehabilitación (AU)

Introduction/objectives. Post-stroke depression has been shown to be the most common psychiatric complication and that which is associated to a worse prognosis. There is still uncertainty as to its etiology and risk factors. Some factors have been established: stroke severity, degree of disability and cognitive impairment. Thus, it is urgent to define new factors that facilitate an early diagnosis, which may lessen the negative effects on the rehabilitation process. Objectives. To determine the incidence of post-stroke depression (PSD) and to study the variables described in the literature as possible predictors of PSD: gender, age, type of stroke, laterality, vascular territory and presence of aphasia. Materials and methods. A retrospective longitudinal study including all patients admitted to a Physical Medicine and Rehabilitation ward, with the diagnosis of stroke de novo, during a period of two years was performed. Initially 144 patients were included. Exclusion criteria were: 'previous stroke', 'prior psychiatric illness with mood disturbance' and 'antidepressant medication at the time of stroke'. The final number was 111 patients. Results. The incidence of PSD was 38.7%. Presence of aphasia showed a significant association with depression (P=0.05). There was no relation with the type of aphasia. The other predictors tested showed no statistically significant correlation. Conclusions. This study establishes aphasia as a predictive factor of PSD. The high incidence of PSD in this population agrees with the existing studies. Further studies are needed, not only to increase the knowledge of the risk factors of PSD but also to improve the outcomes of rehabilitation programs (AU)

Análisis de los factores predictivos de conversión en cirugía laparoscópica colorrectal / Analysis of predictive factors for conversion to open surgery in laparoscopic colorectal surgery

Background: Conversion to open surgery of laparoscopic procedures is not in essence a complication, but invalidates the benefits of laparoscopy. Aim: To identify the predictive factors for conversion in laparoscopic colorectal surgery. Material and Methods: Revision of medical records of all patients with colorectal disease operated using a laparoscopic approach, from 1998 to 2010. Gender, age, American Society of Anesthesiologists (ASA) score, body mass index (BMI), previous abdominal surgery, elective/urgency procedure, benign/malignant disease, type of resection and surgeon experience were recorded. A logistic regression model was done to determine which variables were predictive for conversion to open surgery. Results: The medical records of 582 patients aged 57 +/- 17 years (45 percent men) were analyzed. The rate of conversion to open surgery was 7.1 percent. The logistic regression model selected as predictors of conversion a BMI over 25 kg/m² (odds ratio (OR) 4.9, 95 percent confidence intervals (CI) 2.4 to 9.9), cancer surgery (OR 2.1, 95 percent CI 1.1 to 4.3) and male sex (OR 2.30, 95 percent CI 1.14 to 4.65). The receiver operating curve (ROC) of the model had an are under the curve of 0.766 with 95 percent CI of 0.69 to 0.84). Conclusions: A BMI over 25 kg/m², male sex and the resection of a malignant tumor were predictive factors for conversion to open surgery.

Objetivo: Identificar los factores de riesgo para la conversión en la cirugía laparoscópica colorrectal. Material y Método: Se revisó la base de datos prospectiva de cirugía laparoscópica colorrectal, desde 1998 a 2010. Se analizaron las variables: sexo, edad, ASA, IMC, presencia de cirugía abdominal previa, procedimiento electivo/urgencia, patología benigna/maligna, tipo de resección y experiencia del cirujano. Se realizó un análisis uni y multivariado. Para determinar las variables predictivas de conversión, la totalidad de estas fueron incluidas en un modelo de regresión logística. Resultados: De un total de 621 pacientes consecutivos, la serie se compuso de 582 pacientes (hombres: 45 por ciento, edad promedio: 56,3 años) Tasa de conversión 7,1 por ciento. El modelo de regresión logística seleccionó tres variables como predictivas de conversión: IMC > 25 kg/m² (OR 4,88; IC95 por ciento 2,40-9,92), cirugía por cáncer (OR 2,12; IC95 por ciento 1,11-4,29) y sexo masculino (OR 2,30; IC95 por ciento 1,14-4,65). No fueron predictivas de conversión: edad, comorbilidades, experiencia del cirujano, tipo de procedimiento, ni cirugía previa. La calibración del modelo fue satisfactoria, al igual que su capacidad de discriminación (ABC ROC = 0,766). Conclusiones: En este estudio el IMC sobre 25 kg/m², el sexo masculino y las resecciones por cáncer son factores predictivos independientes de conversión. Este modelo predictivo mostró una calibración satisfactoria, asociada a una capacidad de discriminación acertada para el evento en estudio.

The relation of low glycaemic index fruit consumption to glycaemic control and risk factors for coronary heart disease in type 2 diabetes.

AIMS/HYPOTHESIS: Sugar has been suggested to promote obesity, diabetes and coronary heart disease (CHD), yet fruit, despite containing sugars, may also have a low glycaemic index (GI) and all fruits are generally recommended for good health. We therefore assessed the effect of fruit with special emphasis on low GI fruit intake in type 2 diabetes. METHODS: This secondary analysis involved 152 type 2 diabetic participants treated with glucose-lowering agents who completed either 6 months of high fibre or low GI dietary advice, including fruit advice, in a parallel design. RESULTS: Change in low GI fruit intake ranged from -3.1 to 2.7 servings/day. The increase in low GI fruit intake significantly predicted reductions in HbA(1c) (r = -0.206, p =0.011), systolic blood pressure (r = -0.183, p = 0.024) and CHD risk (r = -0.213, p = 0.008). Change in total fruit intake ranged from -3.7 to 3.2 servings/day and was not related to study outcomes. In a regression analysis including the eight major carbohydrate foods or classes of foods emphasised in the low GI diet, only low GI fruit and bread contributed independently and significantly to predicting change in HbA(1c). Furthermore, comparing the highest with the lowest quartile of low GI fruit intake, the percentage change in HbA(1c) was reduced by -0.5% HbA(1c) units (95% CI 0.2-0.8 HbA(1c) units, p < 0.001). CONCLUSIONS/INTERPRETATION: Low GI fruit consumption as part of a low GI diet was associated with lower HbA(1c), blood pressure and CHD risk and supports a role for low GI fruit consumption in the management of type 2 diabetes. TRIAL REGISTRATION: ClinicalTrials.gov NCT00438698.