Current Overview of Spinocerebellar Ataxia Type 7 in Mexican Population: Challenges in Specialized Care for a Rare Disease.

Spinocerebellar ataxia type 7 (SCA7) is a rare genetic disease characterized by progressive cerebellar syndrome and macular degeneration. In a previous study, we clinically and genetically characterized a group of Mexican patients, which represented one of the largest cohorts of SCA7 patients worldwide and demonstrated that all patients had a unique genetic origin. Our laboratory developed a program for the diagnosis, medical care, and long-term follow-up of these patients living in Veracruz State, and in this report, we present an update to this research, covering 2013 to 2024. So far, we identified 172 SCA7 carriers, with a few cases outside Veracruz, and our data support that the length of the CAG repeat tract mainly determines disease severity and life expectancy, and accordingly, we define three different phenotypes, early-onset (EO), classical-onset (CO), and late-onset (LO), with EO patients showing the lowest life expectancy. Furthermore, we found that parental transmission of mutant alleles leads to increased CAG repeat instability, compared to maternal ones. Interestingly, a haplotype analysis revealed that patients outside Veracruz may have different genetic origins. In conclusion, longitudinal observations of SCA7 patients provide insight into the natural history of SCA7 and help to design strategies for diagnosis, genetic counseling, physical rehabilitation, and therapeutic alternatives.

Understanding the effect of fermentation time on physicochemical characteristics, sensory attributes, and volatile compounds in green tea kombucha.

Kombuchas are a trend in the fermented beverage field and the effect of fermentation time on their characteristics is necessary to better understand the process, mainly concerning volatile compounds, which are scarce information in the current literature. Thus, the present work aimed to evaluate the features of green tea kombucha during fermentation, monitoring the changes in pH, acidity, turbidity, polyphenols, ethanol, acetic acid, volatile compounds, and sensory profile and acceptance up to 14 days of fermentation. Kombuchas' pH and acidity decreased through time as expected, but after 4 days of fermentation, the beverage exceeded the Brazilian legal limits of acidity (130 mEq/L) and produced more than 0.5% AVB, which labels the beverage as alcoholic. Total polyphenols and condensed tannins content enhanced until the seventh day of fermentation and remained constant. Fermentation highly impacted the aroma of the infusion with a high formation of volatile acids, such as alcohols, esters, and ketones. Aldehydes were degraded during the bioprocess. Sensory characterization of kombucha showed that fermentation of 4 days increased perceived turbidity; vinegar, citric fruit, acid, and alcoholic aroma; and produced the beverage with sour, bitter, and vinegar flavor. Thus, the fermentation time of kombuchas must be controlled as they rapidly change and impact on the physicochemical parameters and sensory profile of the beverage can be negative.

Giant Mature Ovarian Cystic Teratoma in a Pediatric Patient: Case Report and Literature Review.

Mature cystic teratomas, also called dermoid cysts, are the most common germ-cell ovarian neoplasms in children. On average, ovarian dermoid cysts are slow-growing neoplasms with a mean size between 6.4 and 7.0 cm that enlarge at a rate of 1.8 mm/year; however, these can reach large dimensions. Giant ovarian tumors are defined as those having a maximum diameter equal to or more than 15 cm; these represent a therapeutic challenge as they increase the risk of wide wound size and surgical invasiveness. In this paper, we present a case of a 10-year-old Hispanic female that complained of abdominal pain, distension, and nausea. Physical examination revealed a mass on the left side of the abdomen and an axial computed tomography found a large pelvic tumor extending to the abdominal region. After a laparotomy approach, pathology evaluation confirmed the diagnosis of mature cystic teratoma. The patient recovered thoroughly and had no complications at a 6-month follow-up. We conducted a literature review including English and Spanish reports about giant ovarian teratomas; we retrieved 16 cases from 2003 to 2023. We concluded that giant ovarian tumors may be underreported, particularly in resource-limited areas where tumors might grow unrecognized, and that English-language bias might play a substantial role in literature reviews involving case reports and case series.

Estilos de vida y alimentación relacionados con el estado nutricional y el riesgo de DM2 en mujeres jóvenes de dos universidades colombianas

Objetivo: Analizar los estilos de vida y alimentación relacionados con el estado nutricional y el riesgo de DM2 y en mujeres estudiantes de dos universidades colombianas. Métodos: Estudio de tipo descriptivo, transversal, multidimensional y exploratorio, realizado en una muestra fue de 220 mujeres, estudiantes de nutrición y dietética (NyD) seleccionadas por muestreo aleatorio de proporciones. Se aplicó un cuestionario para identificar variables sociodemográficas, estilos de vida relacionados con alimentación y el riesgo DM2 según test FINDRISC; se determinó el IMC, perímetro de cintura (PC), porcentaje de grasa e índice de sustancia corporal activa (IAKS). Se realizó análisis bivariado, utilizando Statgraphics v.16, se aplicó la prueba chi2 con 95% de confianza y significancia estadística (p <0,05). Resultados: El sobrepeso y obesidad según IMC (21,4%) mostró significancia estadística con la frecuencia de consumo de bebidas azucaradas, productos de paquete, azúcares y dulces, comidas rápidas y bebidas alcohólicas; estas dos prácticas alimentarias se relacionaron con el riesgo cardiovascular muy alto por PC y con el porcentaje de grasa excesivo que además presentó significancia con el tiempo excesivo en pantallas; el IAKS se relacionó con la clasificación de la actividad física (AF). Según la prueba de FINDRISC, el 91% presentaron factores de riesgo de DM2; el 20,5% presentó riesgo medio y el 2,3% alto. Conclusiones: Los estilos de vida y alimentación se relacionaron con indicadores antropométricos: el peso corporal, la distribución de la grasa y la composición corporal; son factores de riesgo para el desarrollo de DM2 en mujeres jóvenes. Es necesario promover factores protectores para mantener un peso saludable.

Objective: To analyze the lifestyles and diet related to nutritional status and the risk of DM2 and in female students of two Colombian universities. Methods: A descriptive, cross-sectional, multidimensional and exploratory study, carried out in a sample of 220 women, nutrition and dietetic (NaD) students selected by random medsampling of proportions.[1]. A questionnaire was applied to identify sociodemographic variables, lifestyles related to food and DM2 risk according to the FINDRISC test; BMI, waist circumference (WC), fat percentage, and active body substance index (IAKS) were determined. Bivariate analysis was performed using Statgraphics v.16, the chi2 test was applied with 95% confidence and statistical significance (p < 0.05). Results: Overweight and obesity according to BMI (21.4%) showed statistical significance with the frequency of consumption of sugary drinks, packaged products, sugars and sweets, fast foods and alcoholic beverages; These two eating practices were related to very high cardiovascular risk by waist circumference and excessive fat percentage, which also presented significance with excessive screen time; the IAKS was related to the classification of physical activity. According to the FINDRISC test, 91% had DM2 risk factors; 20.5% presented medium risk and 2.3% high. Conclusions: Lifestyle and diet were related to anthropometric indicators: body weight, fat distribution, and body composition; are risk factors for the development of DM2 in young women. It is necessary to promote protective factors to maintain a healthy weight.

The Optimization of Operating Conditions in the Cross-Flow Microfiltration of Grape Marc Extract by Response Surface Methodology.

The recovery of valuable compounds like phenolic compounds and sugars from grape marc extracts implies different steps, including clarification. In this study, a response surface methodology (RSM) was used as a statistical tool to study the effects of operating conditions such as transmembrane pressure (TMP), temperature and feed flow rate on the performance of a microfiltration (MF) monotubular ceramic membrane with a pore size of 0.14 µm in the clarification of grape marc extract from the Carménère variety, as well to optimize the process conditions by implementing the Box-Behnken statistical design. The desirability function approach was applied to analyze the regression model equations in order to maximize the permeate flux and concentration of malvidin-3-O-glucoside, glucose and fructose in the clarified extract. The optimal operating conditions were found to be 1 bar, 29.01 °C and 5.64 L/min. Under these conditions, the permeate flux and concentration of malvidin-3-O-glucoside, glucose and fructose resulted in 65.78 L/m2h, 43.73 mg/L, 305.89 mg/L, and 274.85 mg/L, respectively.

Estudio de validación de la versión chilena de la Evaluación Cognitiva Dinámica de Terapia Ocupacional de Loewenstein (DLOTCA) / Estudo de validação da versão chilena do Loewenstein Dynamic Cognitive Assessment of Occupational Therapy (DLOTCA) / Validation study of the Chilean version of the Dynamic Loewenstein Occupational Therapy Cognitive Assessment (DLOTCA)

Resumen Objetivo Validar la traducción al español chileno de la décima versión en inglés de la Dynamic Loewestein Occupational Therapy Cognitive Assessment para ser utilizado en la población chilena. Método Se realizó la tradución de el DLOTCA al español chileno. Se realizó un pilotaje para la aplicación del instrumento, para lo cual se reclutó a 40 personas adultas con una media de 42,7 años, con diversos daños cerebrales y compuesto por un 70% de mujeres y un 30% de hombres. Para evaluar la confiabilidad del instrumento se calculó el Alfa de Cronbach como medida de Consistencia Interna, aplicando 3 perspectivas, "Fiabilidad Ítem-Total", "Fiabilidad Ítem-Dominio", y "Fiabilidad Dominio-Total". Para medir la Factibilidad se identificó el porcentaje de ítems no contestados por la muestra, y el porcentaje de ítems que es identificado en las pruebas cognitivas como comprendido. Resultados La fiabilidad Ítem-Total arrojó un Alpha de Cronbach 0,953, lo que se traduce en excelente confiabilidad. La fiabilidad Ítem-Dominio, estuvo mayormente entre excelente y buena, existiendo una fiabilidad débil para los factores "orientación temporal" y "percepción visual". La fiabilidad Dominio-Total arrojó un Alpha de Cronbach 0,810 lo que se traduce en una buena confiabilidad. Finalmente, con relación a la factibilidad, los participantes respondieron el 100% de los ítems, evidenciando la accesibilidad de la traducción. Conclusiones El DLOTCA traducido al español chileno; presenta una alta confiabilidad, lo que permite obtener resultados con muy bajos sesgos, convirtiéndose en un instrumento que puede ser utilizado de manera pertinente en la población chilena.

Resumo Objetivo Validar a tradução para o espanhol chileno da décima versão em inglês do Dynamic Loewestein Occupational Therapy Cognitive Assessment (DLOTCA), para uso na população chilena. Método Após a tradução para o espanhol chileno, foi realizado um teste piloto para a aplicação do instrumento, para o qual foram recrutados 40 adultos com idade média de 42,7 anos, com lesões cerebrais diversas e composto por 70% de mulheres e 30% de homens. Para avaliar a confiabilidade do instrumento, calculou-se o Alfa de Cronbach como medida de Consistência Interna, aplicando-se três perspectivas, "Confiabilidade Item-Total", "Confiabilidade Item-Domínio" e "Confiabilidade Total-Domínio". Para medir a viabilidade, identificou-se o percentual de itens não respondidos pela amostra e o percentual de itens identificados nos testes cognitivos como compreendidos. Resultados A confiabilidade Item-Total apresentou um Alfa de Cronbach de 0,953, o que se traduz em excelente confiabilidade. A confiabilidade item-domínio ficou principalmente entre excelente e boa, com confiabilidade fraca para os fatores "orientação temporal" e "percepção visual". A confiabilidade Domínio-Total rendeu um Alfa de Cronbach de 0,810, o que se traduz em boa confiabilidade. Por fim, em relação à viabilidade, os participantes responderam 100% dos itens, evidenciando a tradução ser acessível. Conclusão A DLOTCA, traduzida para o espanhol chileno, apresenta uma alta confiabilidade, o que permite obter resultados com vieses muito baixos, tornando-se um instrumento que pode ser utilizado de forma pertinente na população chilena.

Abstract Objective To validate the Chilean Spanish translation of the tenth English version of the Dynamic Loewestein Occupational Therapy Cognitive Assessment for use in the Chilean population. Method The translation into Chilean Spanish was carried out, and then a pilot test was carried out for the application of the instrument, for which 40 adults were recruited with an average age of 42.7 years, with various brain damages and made up of 70% women and 30% men. To evaluate the reliability of the instrument, Cronbach's Alpha was calculated as a measure of Internal Consistency, applying 3 perspectives, "Item-Total Reliability", "Item-Domain Reliability", and "Domain-Total Reliability". To measure feasibility, the percentage of items not answered by the sample is identified, and the percentage of items that is identified in the cognitive tests as understood. Results The Item-Total reliability yielded a Cronbach's Alpha of 0.953, which translates into excellent reliability. Item-Domain reliability was mostly between excellent and good, with weak reliability for the factors "time orientation" and "visual perception". The Domain-Total reliability yielded a Cronbach's Alpha of 0.810, which translates into good reliability. Finally, in relation to feasibility, the participants answered 100% of the items, evidencing the translation to be accessible. Conclusion The DLOTCA translated into Chilean Spanish; it presents a high reliability, which allows obtaining results with very low biases, becoming an instrument that can be used in a pertinent way in the Chilean population.

Single-Chain Fragment Variable: Recent Progress in Cancer Diagnosis and Therapy.

Cancer remains a public health problem worldwide. Although conventional therapies have led to some excellent outcomes, some patients fail to respond to treatment, they have few therapeutic alternatives and a poor survival prognosis. Several strategies have been proposed to overcome this issue. The most recent approach is immunotherapy, particularly the use of recombinant antibodies and their derivatives, such as the single-chain fragment variable (scFv) containing the complete antigen-binding domains of a whole antibody that successfully targets tumor cells. This review describes the recent progress made with scFvs as a cancer diagnostic and therapeutic tool, with an emphasis on preclinical approaches and their potential use in clinical trials.

Recombinant Attenuated Salmonella enterica as a Delivery System of Heterologous Molecules in Cancer Therapy.

Over a century ago, bacterial extracts were found to be useful in cancer therapy, but this treatment modality was obviated for decades. Currently, in spite of the development and advances in chemotherapies and radiotherapy, failure of these conventional treatments still represents a major issue in the complete eradication of tumor cells and has led to renewed approaches with bacteria-based tumor therapy as an alternative treatment. In this context, live-attenuated bacteria, particularly Salmonella enterica, have demonstrated tumor selectivity, intrinsic oncolytic activity, and the ability to induce innate or specific antitumor immune responses. Moreover, Salmonella enterica also has strong potential as a delivery system of tumor-associated antigens, cytotoxic molecules, immunomodulatory molecules, pro-apoptotic proteins, and nucleic acids into eukaryotic cells, in a process known as bactofection and antitumor nanoparticles. In this review, we present the state of the art of current preclinical and clinical research on the use of Salmonella enterica as a potential therapeutic ally in the war against cancer.

Linfadenitis tuberculosa en niños: Revisión sistemática de reportes de caso

Objetivo: Realizar una revisión sistemática de casos de linfadenitis tuberculosa en niños publicados en la literatura hasta abril de 2022. Materiales y Métodos: Se buscó reportes de casos de linfadenitis tuberculosa por M. tuberculosis en niños, en las bases de datos de Scopus, PubMed, Science Direct, Web of Science, LILACs, Ovid MEDLINE, EBSCO y BMJ Case Reports. Resultados: Se seleccionó 41 reportes, que informaron 46 pacientes. La mayoría fueron varones (52,2%), de 8,5 (5-12) años, con tiempo de enfermedad de 2 (1-5) meses. Las manifestaciones clínicas más frecuentes fueron linfadenopatía palpable (60,9%), fiebre (52,2%) y tos (26,1%). También se encontró pérdida de peso (17,4%), escrófula (15,2%), dificultad respiratoria (13%), hiporexia (13%), dolor localizado (13%), exantema cutáneo (13%), sudoración nocturna (4,3%), dolor abdominal (4,3%) e ictericia (2,2%). Los ganglios cervicales fueron los más comprometidos (71,4%). Solo 17,4% tuvo compromiso pulmonar asociado. El PPD fue positivo en 77,1%, la baciloscopia en 17,2%, la histopatología en 94,1% y el cultivo en 58,8%. Conclusiones: La linfadenitis tuberculosa en niños fue más frecuente en varones, entre 5 y 12 años, inmunizados por BCG y sin contacto conocido de tuberculosis. Los síntomas más frecuentes fueron linfadenopatía palpable, fiebre y tos. Además, se presentaron cuadros atípicos con dificultad respiratoria, dolor localizado, exantema cutáneo, dolor abdominal e ictericia. Los ganglios cervicales fueron los más afectados. El estudio histopatológico fue la prueba con mayor sensibilidad diagnóstica detectando el 94,1% de casos.

Objective: To conduct a systematic review of tuberculous lymphadenitis cases in children published until April 2022. Materials and methods: Case reports of tuberculous lymphadenitis by M. tuberculosis in children were searched in Scopus, PubMed, Science Direct, Web of Science, LILACs, Ovid MEDLINE, EBSCO, and BMC Case Reports databases. Results: Forty-one reports were selected and a total of 46 patients were included. The majority were males (52,2%) of 8,5 (5-12) years old. The time of disease was 2 (1-5) months. The most frequent clinical manifestations were palpable lymphadenopathy (60,9%), fever (52,2%) and cough (26,1%). Weight loss (17,4%), scrofula (15,2%), respiratory distress (13%), hyporexia (13%), localized pain (13%), skin rash (13%), night sweats (4.3%), abdominal pain (4.3%) and jaundice (2,2%) were also founded. Cervical nodes were most frequently involved (71,4%). Only 17,4% were associated with lung involvement. PPD was positive in 77.1%, bacilloscopy in 17.2%, histopathology in 94,1% and culture in 58,8%. Conclusions: Tuberculous lymphadenitis in children was more frequent in boys, between 5 and 12 years, immunized by BCG and without known contact with tuberculosis. The principal symptoms were palpable lymphadenopathy, fever and cough. However, atypical symptoms were respiratory difficulty, localized pain, skin rash, abdominal pain, and jaundice. Cervical nodes were the most affected. The test with greatest sensitivity was the histopathological study which detected 94,1% of cases.

Ejercicio físico y el riesgo de cáncer hepático / Physical exercise and the risk of hepatic cancer

RESUMEN Introducción. El hígado es el mayor órgano sólido, desempeña muchas funciones en el cuerpo. El ejercicio físico es valorado como una intervención no farmacológica eficiente en el fomento del bienestar físico, mental y funcional de pacientes con cáncer. Objetivos. Determinar los efectos del ejercicio físico en el cáncer hepático y sintetizar estudios prospectivos sobre la asociación de la actividad física y el ejercicio físico con el riesgo de cáncer de hígado. Metodología. Revisión sistemática con análisis retrospectivo y descriptivo de artículos científicos publicados en bases de datos indexadas de enero del año 2008 a junio del 2019. Así mismo, se llevó a cabo la selección y evaluación de los archivos por medio de la Declaración de PRISMA, PICO, Cochrane y escala de PEDro. Resultados. Se encontró que la actividad física se asocia con un riesgo reducido de desarrollar cánceres de hígado (IC95%: 0,38-0,80). El ejercicio aeróbico redujo los lípidos hepáticos (grasa hepática 8.9±3.2 a 5.6±1.8%; p <0.05, grasa visceral 54,7±6,0 a 49,6±5,5cm2; p <0,05) y el ejercicio de resistencia aumentó la sensibilidad a la insulina (5.9±5.9 a 4.6±4.6 vs 4.7±2.1 a 5.1±2.5; p<0.05), mejoró la flexibilidad metabólica (-0.0206±0.010 vs 0.004±0.003; p<0.05). Conclusiones. La actividad física y el ejercicio representan un papel importante dentro de la enfermedad del cáncer, ya que se asocia con un menor riesgo de desarrollarlo, así como aminorar la sintomatología que conlleva en especial el cáncer hepático.

ABSTRACT Introduction. The liver is the largest solid organ; it performs many functions in the body. Physical exercise is valued as an efficient non-pharmacological intervention in the promotion of physical, mental and functional well-being of cancer patients. Objectives: To determine the effects of physical exercise on liver cancer and synthesize prospective studies on the association of physical activity and physical exercise with the risk of liver cancer. Methodology. Systematic review with retrospective and descriptive analysis of scientific articles published in indexed databases from January 2008 to June 2019. Likewise, the selection and evaluation of the archives was carried out through the Declaration of PRISMA, PICO, Cochrane and PEDro´s scale. Results. It was found that physical activity is associated with a reduced risk of developing liver cancers (95%CI 0.38-0.80). Aerobic exercise reduced liver lipids (liver fat 8.9±3.2 to 5.6±1.8%; p<0.05, visceral fat 54.7±6.0 to 49.6±5.5cm2; p<0.05) and resistance exercise increased insulin sensitivity (5.9 ± 5.9 to 4.6±4.6 vs. 4.7±2.1 to 5.1±2.5; p <0.05), improved metabolic flexibility (-0.0206± 0.010 vs. 0.004±0.003; p <0.05). Conclusions. Physical activity and exercise represents an important role in cancer disease, since it is associated with a lower risk of developing it, as well as reduce the symptoms which is especially associated with liver cancer.

Adaptación al español chileno de la Evaluación Cognitiva Dinámica de Terapia Ocupacional de Loewenstein (DLOTCA) / Adaptação Transcultural para o espanhol chileno da Avaliação Cognitiva Dinâmica de Terapia Ocupacional de Loewenstein (DLOTCA) / Adaptation to Chilean Spanish of Dynamic Loewenstein Occupational Therapy Cognitive Assessment (DLOTCA)

Resumen Objetivo Adaptar la décima versión en inglés de la Dynamic Loewestein Occupational Therapy Cognitive Assessment al español chileno. Método Se realizó adaptación al español del manual de aplicación de DLOTCA. El proceso siguió las pautas generales para la traducción y adaptación de instrumentos de la Organización Mundial de la Salud (OMS), con traducción directa, panel de discusión de expertos, retrotraducción, pruebas previas y entrevistas cognitivas con usuarios. Resultados Se obtuvo una traducción directa al español por dos terapeutas ocupacionales bilingües que fue sometida a ajustes por un panel de expertos compuesto por 6 terapeutas ocupacionales, del total de 28 sub test el comité de expertos no tuvo discrepancia en 20 de ellos, de los 8 restantes se realizaron modificaciones. Se realiza una retrotraducción de la versión obtenida, donde solo hubo discrepancias con un término lo que fue resuelto por el equipo investigador. Finalmente se aplicó una prueba previa/pre test a 13 personas adultas con daño cerebral, los ajustes en esta etapa fueron ortográficos y de sustitución de algunos términos por palabras más comúnmente utilizados en la lengua chilena, verificando la consistencia en la comprensión de los ítems independientemente de los resultados obtenidos. Se produjeron tres versiones antes de la versión final, todas las etapas se desarrollaron de manera sistemática, logrando una traducción comprensible y consistente con la población chilena. Conclusiones Finalmente se ha puesto a disposición de la comunidad científica una versión en español chileno del instrumento DLOTCA.

Resumo ObjetivoAdaptar a décima versão em inglês do Dynamic Loewestein Occupational Therapy Cognitive Assessment para o espanhol chileno. MétodoO manual de aplicação DLOTCA foi adaptado para o espanhol. O processo seguiu as diretrizes gerais para tradução e adaptação de instrumentos da Organização Mundial da Saúde (OMS), com tradução direta, painel de discussão de especialistas, retrotradução, pré-testes e entrevistas cognitivas com os usuários. ResultadosA tradução direta para o espanhol foi obtida por dois terapeutas ocupacionais bilíngues que foi submetida a ajustes por um painel de especialistas composto por 6 terapeutas ocupacionais, do total de 28 subtestes, o comitê de especialistas não apresentou discrepância em 20 deles, das quais 8 modificações restantes foram feitas. Foi realizada a retrotradução da versão obtida, com apenas discrepâncias com um termo, o que foi resolvido pela equipe de pesquisa. Por fim, uma prova prévia / pré-teste foi aplicado a 13 adultos com lesão cerebral, os ajustes nesta etapa foram de grafia e substituição de alguns termos por palavras mais utilizadas na língua chilena, verificando a consistência na compreensão dos itens, independentemente dos resultados obtidos. Três versões foram produzidas antes da versão final, toda as etapas foram desenvolvidas de forma sistemática, alcançando uma tradução compreensível e consistente para a população chilena. Conclusões: Uma versão em espanhol chileno do instrumento DLOTCA foi finalmente disponibilizada para a comunidade científica.

Abstract Objective To adapt the tenth version in English of the Dynamic Loewenstein Occupational Therapy Cognitive Assessment to Chilean Spanish. Method The DLOTCA application manual was adapted into Spanish. The process followed the general guidelines for the translation and adaptation of instruments of the World Health Organization (WHO), with direct translation, a panel discussion of experts, back translation, pre-tests, and cognitive interviews with users. Results A direct translation into Spanish was obtained by two bilingual occupational therapists that were subjected to adjustments by a panel of experts composed of 6 occupational therapists, of the total of 28 sub-tests, the expert committee had no discrepancy in 20 of them, of which 8 remaining modifications were made. A back translation of the version obtained is carried out, where there were only discrepancies with one term, which was resolved by the research team. Finally, a pre-test was applied to 13 adults with brain damage, the adjustments in this stage were spelling and substitution of some terms for words more commonly used in the Chilean language, verifying the consistency in the understanding of the items independently of the results obtained. Three versions were produced before the final version, all stages were developed in a systematic way, achieving an understandable and consistent translation with the Chilean population. Conclusions A version in Chilean Spanish of the DLOTCA instrument has finally been made available to the scientific community.

Diferencia de la incidencia de los efectos adversos, entre la primera y la segunda dosis de la vacuna Pfizer/Biontech en el personal de salud / Difference in the incidence of adverse effects between the first and second doses of thr Pfizer/Biontech vaccine in health workers

Objetivo: comparar la incidencia de los efectos adversos entre la primera y segunda dosis de la vacuna Pfizer/BioNTech en personal de salud. Material y métodos: estudio transversal analítico en trabajadores de salud que recibieron la primera y segunda dosis de la vacuna COVID-19 de Pfizer/BioNTech. La muestra fue de 540 pacientes. la comparación del promedio de síntomas en la primera y segunda dosis se realizó con la prueba de Wilcoxon para dos poblaciones. Resultados: los síntomas locales fueron estadísticamente diferentes entre la primera y la segunda dosis (Wilcoxon = 2,78, p = 0,005). El promedio de síntomas sistémicos en la primera dosis fue estadísticamente superior en los pacientes con antecedente de COVID-19 que en aquellos que no lo presentaron (Mann-Withney = 4,36, p = 0,006). Conclusión: hubo diferencia en la sintomatología local, siendo mayor en la primera dosis. Los pacientes con antecedente de COVID-19 tienen una mayor expresión de síntomas sistémicos tras la primera dosis.

Atypical Association of Autoimmune Limbic Encephalitis with Anti-NMDA Receptor Antibodies in a Young Male Patient: Clinical, Imaging, and Neuropsychological Characteristics.

The spectrum of autoimmune encephalitis (AE) encompasses several entities characterized by a variable frequency of psychiatric symptoms, cognitive dysfunction, focal deficits, and seizures. Although patients with AE can be categorized in specific syndromes, overlapping manifestations are also common. Furthermore, atypical correlations between clinical phenotypes and autoantibody profiles could occur in rare cases. Here, we report the rare case of a young adult man attending due to new-onset seizures and a history of memory loss, autonomic disturbances, headache, behavioral changes, and visual and olfactory hallucinations. The patient was subjected to a complete diagnostic approach that included a comprehensive laboratory workup, neuropsychological testing, electroencephalogram, cerebrospinal fluid (CSF) analysis, brain MRI, and positron emission tomography/computed tomography scan that revealed a functional and structural compromise of the bilateral medial temporal lobes. Together with the clinical manifestations of the patient, these findings were compatible with the diagnosis of autoimmune limbic encephalitis (ALE). Strikingly, further analysis of the CSF showed autoantibodies against the N-methyl-D-aspartate (NMDA) receptor. We found very few cases of the co-occurrence of anti-NMDA receptor antibodies and nonparaneoplastic ALE in the literature, especially in male patients. Our report exemplifies the complicated differential diagnosis of ALE and adds clinical information of the association with anti-NMDA receptor antibodies.

Recovery of Anthocyanins and Monosaccharides from Grape Marc Extract by Nanofiltration Membranes.

Wastewaters and by-products generated in the winemaking process are important and inexpensive sources of value-added compounds that can be potentially reused for the development of new products of commercial interest (i.e., functional foods). This research was undertaken in order to evaluate the potential of nanofiltration (NF) membranes in the recovery of anthocyanins and monosaccharides from a clarified Carménère grape marc obtained through a combination of ultrasound-assisted extraction and microfiltration. Three different flat-sheet nanofiltration (NF) membranes, covering the range of molecular weight cut-off (MWCO) from 150 to 800 Da, were evaluated for their productivity as well as for their rejection towards anthocyanins (malvidin-3-O-glucoside, malvidin 3-(acetyl)-glucoside, and malvidin 3-(coumaroyl)-glucoside) and sugars (glucose and fructose) in selected operating conditions. The selected membranes showed differences in their performance in terms of permeate flux and rejection of target compounds. The NFX membrane, with the lowest MWCO (150-300 Da), showed a lower flux decay in comparison to the other investigated membranes. All the membranes showed rejection higher than 99.42% for the quantified anthocyanins. Regarding sugars rejection, the NFX membrane showed the highest rejection for glucose and fructose (100 and 92.60%, respectively), whereas the NFW membrane (MWCO 300-500 Da) was the one with the lowest rejection for these compounds (80.57 and 71.62%, respectively). As a general trend, the tested membranes did not show a preferential rejection of anthocyanins over sugars. Therefore, all tested membranes were suitable for concentration purposes.

Respuestas cardiovasculares de pacientes con obesidad en la prueba de esfuerzo / Cardiovascular responses of obese patients to exercise stress test

RESUMEN Introducción: La obesidad es una enfermedad multisistémica que constituye un factor de riesgo coronario y se asocia frecuentemente a otros, como la hipertensión arterial, la diabetes y la dislipidemia, todo lo cual aumenta el riesgo de enfermedad cardiovascular. Objetivo: Determinar la respuesta cardiovascular de los pacientes con obesidad durante una prueba de esfuerzo. Método: Estudio observacional, descriptivo y transversal con 67 participantes obesos (45 mujeres y 22 hombres), con promedio de edad de 35±12,6 años. Para el desarrollo de esta investigación se obtuvieron variables antropométricas, signos vitales, escala de Borg, cuestionario para factores de riesgo cardiovascular, y se realizó una prueba de esfuerzo en tapiz rodante con protocolo de Bruce. Resultados: Los principales factores de riesgo cardiovascular encontrados fueron el sedentarismo (100%) y los antecedentes patológicos familiares (76%). Se obtuvo una frecuencia cardíaca máxima promedio de 172,82±18,81 latidos por minuto, que fue superior en las mujeres (173,9±17,5 vs. 168,9±22,1) y al asociarla con los factores de riesgo cardiovascular se encontró que fue mayor en los pacientes con menos de 4 factores de este tipo (179,4±17,7 vs. 167,1±18,6). Conclusiones: Se encontró una disminución de la respuesta cardiovascular en relación con el esfuerzo esperado para la prueba de esfuerzo. A mayor número de factores de riesgo cardiovascular presentes, menor fue la frecuencia cardíaca máxima alcanzada.

ABSTRACT Introduction: Obesity is a multisystemic disease and a coronary risk factor that is frequently associated with others, such as high blood pressure, diabetes and dyslipidemia. These all increase the risk of heart disease. Objective: We aimed to determine the cardiovascular response of obese patients during a stress test. Methods: An observational, descriptive and cross-sectional study was conducted with 67 obese participants (45 women and 22 men) aged 35±12.6 years on average. To develop our research, we analyzed anthropometric variables and vital signs. The Borg scale, a cardiovascular risk factor interview and a Bruce treadmill stress test protocol were also applied. Results: The main cardiovascular risk factors found were sedentary lifestyle (100%) and family history of disease (76%). An average maximum heart rate of 172.82±18.81 beats per minute was obtained, which was higher in women (173.9±17.5 vs. 168.9±22.1). It was found to be higher in patients with less than four cardiovascular risk factors (179.4±17.7 vs. 167.1±18.6) when associated with cardiovascular risk factors. Conclusions: A decrease in cardiovascular response was found in relation to the expected test effort. The greater the number of cardiovascular risk factors, the lower the maximum heart rate achieved.

Impact of Membrane Pore Size on the Clarification Performance of Grape Marc Extract by Microfiltration.

The influence of membrane pore size on the permeate flux, fouling mechanism, and rejection of soluble and suspended solids, as well as of phenolics and anthocyanins, in the clarification of grape marc extract by microfiltration (MF) was studied. MF was operated by using three monotubular ceramic membranes with a pore size of 0.14, 0.2, and 0.8 µm, respectively, according to a batch concentration configuration in selected operating conditions (2.25 bar as operating pressure, 4.93 L/min as feed flow rate, and 25 °C as operating temperature). No significant differences in the permeate flux values were appreciated despite the difference in pore size. The mathematical analyses of the flux behavior revealed that intermediate pore blocking is the predominant mechanism for 0.14 and 0.2 µm membranes, whereas complete pore blocking prevails for the 0.8 µm membrane. Differences in the fouling mechanism were associated with differences in the total phenols rejection: the highest rejection was observed for the 0.8 µm membrane followed by 0.2 and 0.14 µm membranes. All selected membranes showed low rejection of sugars, with values lower than 10%, and no retention towards anthocyanins. All the clarified extracts showed a turbidity lower than 4.87 NTU. Based on the experimental results, the 0.14 µm membrane appeared as the best option for the clarification of grape marc extract.

Cambios hemodinámicos y calidad de vida en pacientes con cáncer de próstata luego de un entrenamiento HIIT Y MICT: ensayo clínico aleatorizado (ONCO-EXE TRIAL) / Hemodynamic changes and quality of life in patients with prostate cancer after a HIIT and MICT training: a randomized clinical trial (ONCO-EXE TRIAL)

Introducción. El cáncer de próstata es el más frecuente en hombres y constituye la segunda causa de mortalidad. La rehabilitación basada en ejercicios se muestra efectiva y segura para mitigar los efectos del cáncer. Objetivo. Determinar los cambios hemodinámicos y calidad de vida en pacientes con cáncer de próstata luego de un entrenamiento de alta intensidad (HIIT) o continuo, a intensidad moderada (MICT). Métodos. Ensayo clínico aleatorizado con 249 pacientes con cáncer de próstata en estadio II distribuidos en tres grupos (MICT, HIIT y grupo control) a quienes se les aplicó el cuestionario EORTC QLQ C-30 para calidad de vida, ecocardiograma, prueba de esfuerzo, signos vitales y la escala FACT-Fatigue Scale. El programa de entrenamiento tuvo una duración de 36 sesiones de 70 minutos, tres veces por semana. Resultados. Al comparar los resultados post entrenamiento de las variables hemodinámicas, logramos determinar cambios en la fracción de eyección (GE1: 49,0 ± 5,6 vs 52,0 ± 5,4; GE2: 45,0 ± 5,3 vs 51,0 ± 3,2; GC: 48,0 ± 4,1 vs 48,0 ± 4,4; p<0,005), frecuencia cardíaca máxima (GE1: 155,0 ± 7,0 vs 159,0 ± 4,0; GE2: 156,0 ± 14,0 vs 168,0 ± 5,0; GC: 155,0 ± 7,0 vs 155,0 ± 6,0; p<0,005). Al igual que los resultados para calidad de vida (GE1: 55,1 ± 10,3 vs 70,9 ± 10,2; GE2: 59,8 ± 9,9 vs 118,0 ± 14,6; GC: 60,2 ± 7,6 vs 62,3 ± 9,4; p<0,005). Conclusiones. El HIIT y MICT mejoraron significativamente la calidad de vida, fatiga, y todas las variables hemodinámicas evaluadas en la investigación. Se demostró mayores beneficios con el HIIT. El grupo control de atención habitual sin entrenamiento físico, no presentó cambios significativos.

Introduction. Prostate cancer is the most common in men and is the second cause of death. Exercise-based rehabilitation is effective and safe in mitigating cancer effects. Objective. To determine the hemodynamic changes and quality of life in prostate cancer after a high intensity training (HIIT) or continuous to moderate intensity (MICT). Methods. A randomized clinical trial with 249 patients with stage II prostate cancer divided into 3 groups (MICT, HIIT and control group) who were applied EORTC QLQ C-30 questionnaire for quality of life, echocardiogram, stress test, vital signs and FACT-Fatigue Scale. The training program lasted 36 sessions of 70 minutes, 3 times a week. Results. When comparing the post-training results of the hemodynamic variables, we managed to determine changes in the ejection fraction (GE1: 49.0 ± 5.6 vs 52.0 ± 5.4, GE2: 45.0 ± 5.3 vs 51.0 ± 3.2, GC: 48.0 ± 4.1 vs 48.0 ± 4.4 p<0.005), maximum heart rate (GE1: 155.0 ± 7.0 vs 159.0 ± 4.0, GE2: 156.0 ± 14.0 vs 168.0 ± 5.0, GC: 155.0 ± 7.0 vs 155 ± 6.0, p<0.005). As in the results for quality of life (GE1: 55.1 ± 10.3 vs 70.9 ± 10.2, GE2: 59.8 ± 9.9 vs 118.0 ± 14.6, GC: 60.2 ± 7.6 vs 62.3 ± 9.4, p<0.005). Conclusions. HIIT and MICT significantly improved the quality of life, fatigue, and all hemodynamic variables evaluated in the research. Greater benefits were demonstrated with HIIT. The usual care control group without physical training did not show significant changes.

Ketamina nebulizada para la prevención del dolor faríngeo postoperatorio / Nebulised ketamine for preventing postoperative pharyngeal pain

Resumen: Introducción: El dolor faríngeo postoperatorio es una complicación frecuente posterior a la intubación endotraqueal, caracterizado por odinofagia. Objetivo: Comparar ketamina nebulizada preoperatoria contra placebo para la disminución del dolor faríngeo postoperatorio en cirugía electiva bajo anestesia general. Material y métodos: Estudio experimental prospectivo, aleatorizado, doble ciego, realizado de febrero a julio del 2016. Dos grupos de pacientes aleatorizados: grupo K: ketamina nebulizada (50 mg: 1 mL de ketamina + 2 mL de solución salina 0.9%); grupo P: placebo (nebulización de 3 mL solución salina 0.9%). Se evaluaron signos vitales así como síntomas e intensidad del dolor faríngeo postoperatorio de acuerdo con la escala numérica análoga a la hora 1 y a la hora 4. Resultados: El uso de ketamina nebulizada no representa una ventaja estadísticamente significativa con relación al placebo para el dolor faríngeo postoperatorio. La incidencia de éste en nuestro estudio fue de 59.29%. Conclusiones: Se necesitan más estudios con ketamina nebulizada en vía aérea difícil en la población mexicana, así como una mayor muestra para poder determinar el estándar de oro para el tratamiento del dolor faríngeo postoperatorio.

Abstract: Introduction: The postoperative sore throat is a frequent complication, characterized by odynophagia after endotracheal intubation. Objective: To compare nebulized ketamine in the preoperative period against nebulized placebo for the reduction of the postoperative sore throat on elective surgery under general anesthesia. Material and methods: We performed an experimental, prospective, randomized, double blind study; conducted from February to July 2016. Patients were randomly assigned into two groups: group K: preoperative nebulized ketamine (50 mg: 1 mL of ketamine + 2 mL of saline solution 0.9%) against group P: placebo (nebulization of 3 mL saline solution 0.9%). We collected vital signs as well as symptoms and intensity of postoperative sore throat according to the analog numeric scale at the first and forth postoperative hours. Results: The use of nebulized ketamine does not represent a statistically significant difference compared to placebo for postoperative sore throat. The incidence of postoperative sore throat in our study was of 59.29%. Conclusions: We need further studies of nebulized ketamine in the Mexican population, as well as a larger study to determine the gold standard for the treatment of POST.

Effects of Physical Rehabilitation in Patients with Spinocerebellar Ataxia Type 7.

Today, neurorehabilitation has become in a widely used therapeutic approach in spinocerebellar ataxias; however, there are scarce powerful clinical studies supporting this notion, and these studies require extension to other specific SCA subtypes in order to be able to form conclusions concerning its beneficial effects. Therefore, in this study, we perform for the first time a case-control pilot randomized, single-blinded, cross-sectional, and observational study to evaluate the effects of physical neurorehabilitation on the clinical and biochemical features of patients with spinocerebellar ataxia type 7 (SCA7) in 18 patients diagnosed with SCA7. In agreement with the exercise regimen, the participants were assigned to groups as follows: (a) the intensive training group, (b) the moderate training group, and (c) the non-training group (control group).We found that both moderate and intensive training groups showed a reduction in SARA scores but not INAS scores, compared with the control group (p < 0.05). Furthermore, trained patients exhibited improvement in the SARA sub-scores in stance, gait, dysarthria, dysmetria, and tremor, as compared with the control group (p < 0.05). No significant improvements were found in daily living activities, as revealed by Barthel and Lawton scales (p > 0.05). Patients under physical training exhibited significantly decreased levels in lipid-damage biomarkers and malondialdehyde, as well as a significant increase in the activity of the antioxidant enzyme PON-1, compared with the control group (p < 0.05). Physical exercise improved some cerebellar characteristics and the oxidative state of patients with SCA7, which suggest a beneficial effect on the general health condition of patients.

Diseño de un instrumento de evaluación de desempeño en actividades de la vida diaria / Design of a performance evaluation instrument for the activities of daily living

RESUMEN Objetivos Diseñar y validar un instrumento de evaluación del desempeño de las AVDI, acorde a las necesidades y características actuales de los adultos considerando la actualización terminológica en Terapia Ocupacional. Métodos La investigación se encasilla como un estudio investigativo-evaluativo cuantitativo multivariado. Se diseñó un instrumento de tres dimensiones, una para valorar el nivel de desempeño, otra para valorar las razones de dependencia y una tercera para valorar la importancia de la actividad. Se realizó una prueba de campo a una muestra de 38 personas, usuarios de Centros de Rehabilitación Comunitaria y posteriormente el instrumento diseñado se sometió a validación de constructo y de contenido, a través de juicio de expertos y análisis factorial a los datos a una muestra de 89 personas adultas según los criterios de inclusión. Resultados El análisis se realizó mediante validación de constructo a través de un análisis estadístico factorial, identificando y obteniendo en las tres dimensiones un alfa de Cronbach con valores por sobre 0,7 lo que resulta en un instrumento fiable. Conclusión Gracias a la validación de contenido y construcción, se establece que el instrumento es adecuado para la población propuesta, por lo tanto, se puede difundir y utilizar para contribuir a la disciplina.(AU)

ABSTRACT Objective To design and validate an instrument for a performance evaluation of the instrumental activities of daily living according to the current needs and features of adults, considering the terminological update in Occupational Therapy. Materials and Methods This is a multivariate, quantitative, evaluation research study. A three-dimensional instrument was designed, one to assess the level of performance, another to assess the reasons for dependency and a third one to assess the importance of the activity. A field test was carried out in 38 users of community rehabilitation centers. Subsequently, the designed instrument was submitted to construct and content validation through expert judgment and factorial analysis of data from a sample of 89 people from the aforementioned rehabilitation centers according to the inclusion criteria. Results An analysis was performed by means of construct validation through a factorial statistical analysis. A Cronbach's alpha value above 0.7 was obtained for the three dimensions of the instrument, which results in a reliable instrument. Conclusion Due to the content and construct validation, together with a statistical analysis of its dimensions, the instrument can be considered as a suitable tool for the proposed population and can therefore be disseminated and used within this discipline.(AU)