Cholera and diarrheal diseases in Cuamba District, Niassa Province, Mozambique: Systematic healthcare facility-based surveillance strengthening, characteristics of suspected cholera and diarrheal patients, and incidence of diarrheal diseases.

BACKGROUND: Mozambique is one of the countries in Africa that is continuously at risk of cholera outbreaks due to poor sanitation, hygiene, and limited access to potable water in some districts. The Mozambique Cholera Prevention and Surveillance (MOCA) project was implemented in Cuamba District, Niassa Province to prevent and control cholera outbreaks through a preemptive cholera vaccination, strengthened surveillance system for cholera and diarrheal diseases, and better understanding of cholera-related healthcare seeking behavior of local populations, which may further guide the national cholera control and prevention strategies. This article presents the surveillance component of the MOCA project. METHODOLOGY/PRINCIPAL FINDINGS: A prospective healthcare facility (HCF)-based surveillance of cholera and diarrheal disease was conducted in six HCFs in the District of Cuamba from March 2019 to December 2020. A systematic surveillance procedure has been put in place with capacity building in selected sentinel HCFs and a basic microbiology laboratory established on-site. Patients presenting with suspected cholera or other diarrheal symptoms were eligible for enrollment. Clinical data and rectal swab samples were collected for laboratory confirmation of Vibrio Cholerae and other pathogens. A total of 419 eligible patients from six HCFs were enrolled. The median age was 19.8 years with a similar age distribution between sentinel sites. The majority were patients who exhibited diarrhea symptoms not suspected of cholera (88.8%; n = 410). Among those, 59.2% (210/397) were female and 59.9% (235/392) were 15 years and above. There were 2 cholera cases, coming outside of the catchment area. The incidence of diarrheal diseases ranged from 40-103 per 100,000 population. No Vibrio cholerae was isolated among surveillance catchment population and Escherichia coli spp. (82/277; 29.6%) was the most common pathogen isolated. CONCLUSION/SIGNIFICANCE: Efforts were made to strengthen the systematic surveillance of suspected cholera with standardised patient screening, enrolment, and diagnostics. The first basic microbiology laboratory in Niassa Province established in Cuamba District under the MOCA project needs to be integrated into the national network of laboratories for sustainability. No reports of laboratory confirmed cholera cases from the surveillance catchment area may be highly related to the pre-emptive oral cholera vaccine (OCV) mass vaccination campaign conducted in 2018 and the use of drugs by local populations prior to visiting the sentinel HCFs. Continued systematic cholera surveillance is needed to closely monitor the cholera endemicity and epidemics, and further evaluate the long-term impact of this vaccination. High incidence of diarrheal illnesses needs to be addressed with improved water, sanitation, and hygiene (WaSH) conditions in Cuamba District. Efforts integrated with the prioritization of prevention measures are fundamental for the control of cholera in the country.

Automating behavioral analysis in neuroscience: Development of an open-source python software for more consistent and reliable results.

BACKGROUND: The application of automated analyses in neuroscience has become a practical approach. With automation, the algorithms and tools employed perform fast and accurate data analysis. It minimizes the inherent errors of manual analysis performed by a human experimenter. It also reduces the time required to analyze a large amount of data and the need for human and financial resources. METHODS: In this work, we describe a protocol for the automated analysis of the Morris Water Maze (MWM) and the Open Field (OF) test using the OpenCV library in Python. This simple protocol tracks mice navigation with high accuracy. RESULTS: In the MWM, both automated and manual analysis revealed similar results regarding the time the mice stayed in the target quadrant (p = 0.109). In the OF test, both automated and manual analysis revealed similar results regarding the time the mice stayed in the center (p = 0.520) and in the border (p = 0.503) of the field. CONCLUSIONS: The automated analysis protocol has several advantages over manual analysis. It saves time, reduces human errors, can be customized, and provides more consistent information about animal behavior during tests. We conclude that the automated protocol described here is reliable and provides consistent behavioral analysis in mice. This automated protocol could lead to deeper insight into behavioral neuroscience.

Parental report of dental pain and discomfort in preschool children is associated with sleep disorders: a cross-sectional study in Brazilian families.

PURPOSE: To evaluate the prevalence of sleep disorders in Brazilian preschool children and its associations with parental report of dental pain and discomfort. METHODS: This cross-sectional study involved 604 Brazilian preschoolers (4-5 years old). Sleep disorders (SD) and the parental report of dental pain and discomfort (DPD) were evaluated using the Brazilian versions of the Sleep Disturbance Scale for Children (SDSC) and the Dental Discomfort Questionnaire (DDQ-B), respectively. Bivariate and multivariate Poisson regression analyses with robust variance were performed to analyze the association between SDSC and DP. RESULTS: Prevalence of SD ranged from 7 to 21%. 7.9% of the children had DPD indicating the need for more invasive dental procedures (DDQ-B ≥ 5). Significant associations were found between DPD and the following SDSC domains: sleep hyperhidrosis (p = 0.024; PRa = 1.38; 95% CI: 1.04-1.83), disorders of initiating and maintaining sleep (p < 0.001; PRa = 1.41; 95% CI: 1.15-1.73), parasomnias (p < 0.001; PRa = 1.82; 95% CI: 1.39-2.37), and sleep-wake transition disorders (p = 0.018; PRa = 1.28; 95% CI: 1.04-1.58). Children with higher prevalence of DPD presented 20% higher prevalence of SD than children lower prevalence of DPD (p = 0.039; PRa = 1.20; 95% CI: 1.01-1.44). CONCLUSION: Preschool children with higher prevalence of DPD are more likely to have SD, such as hyperhidrosis, disorders of initiating and maintaining sleep, parasomnias, and sleep-wake transition.

Descripción de las tasas de mortalidad por cáncer gástrico como causa básica entre los años 2017 a 2021 en Chile / Description of death rates due to gastric cancer as a basic cause between 2017 and 2021 in Chile

Introducción: El cáncer gástrico, en Chile, ocupa el primer lugar como causa de mortalidad por tumores malignos, por ello, es de suma importancia conocer la descripción demográfica de esta enfermedad en el país. El periodo en estudio 2017-2021 entrega información actualizada a la salud pública. Metodología: Estudio ecológico, observacional, transversal y descriptivo sobre defunciones por cáncer gástrico en el periodo 2017-2021 en Chile según sexo, grupo etario y regiones (n=15350). Se calculó la tasa de mortalidad (TM). Información obtenida del Departamento de Estadística e Información de Salud e Instituto Nacional de Estadísticas, por lo que no requiere comité de ética. Resultados: Durante el periodo 2017-2021 la TM general fue de 21,84, siendo 21,58 en hombres y 10,68 en mujeres. En edad, el mayor valor se presentó en el grupo de 80 y más años y el menor valor en el grupo de 15-19 años. La TM del periodo general más alta la obtuvo la Región Metropolitana. Discusión: Se evidenció una reducción de la TM entre los años 2017-2021, pudiéndose deber al aumento de tamizaje y tratamiento de Helicobacter pylori. Además, se observó que la TM es mayor en hombres, explicado por su mayor susceptibilidad genética a desarrollar cáncer. La menor TM se registró entre 15-19 años, y la mayor en el grupo 80 y más años, lo que concuerda con literatura internacional. Conclusión: Se necesitan más estudios nacionales para ahondar en los resultados encontrados que permitan darle continuidad a la investigación, y que determinen factores de riesgo específicos de la población chilena.

Introduction: Gastric cancer in Chile takes the first place as a cause of mortality from malignant tumors, therefore it is relevant to know the demographic description of this disease in the country. Studied years go from 2017-2021 in order to get updated data to the Chilean public health. Methodology: Ecological, observational, cross-sectional and descriptive study on deaths due to gastric cancer in 2017-2021 in Chile, according to sex, age group and regions (n=15350). The death rate was calculated. Data was obtained from the Department of Statistics and Health Information and the National Institute of Statistics. It did not require approval from an ethics committee. Results: During the 2017-2021 period the overall death rate was 21.84, 21,58 for men and 10,68 for women. The highest values were in the 80 and older age group and the lowest values in the 15-19 years age group. The highest death rate overall period was registered in the Metropolitan Region. Discussion: There was a reduction in the hospital death rate between 2017-2021, which could be due to the increase in screening and treatment of Helicobacter pylori. Death rate is higher in men, which could be explained because they are more genetically susceptible to developing cancer. The lowest values for death rate were found in the 15-19 years age group, and the highest values in the 80 years and older group, which is consistent with international literature. Conclusion: More studies are required in Chile to broaden the findings to allow investigation continuity and to determine specific risk factors present in the Chilean population.

Pre-emptive oral cholera vaccine (OCV) mass vaccination campaign in Cuamba District, Niassa Province, Mozambique: feasibility, vaccination coverage and delivery costs using CholTool.

INTRODUCTION: Mozambique suffers from regular floods along its principal river basins and periodic cyclones that resulted in several cholera epidemics during the last decades. Cholera outbreaks in the recent 5 years affected particularly the northern provinces of the country including Nampula and Niassa provinces. A pre-emptive oral cholera vaccine (OCV) mass vaccination campaign was conducted in Cuamba District, Niassa Province, and the feasibility, costs, and vaccination coverage assessed. METHODS: WHO prequalified OCV (Euvichol-Plus), a killed whole-cell bivalent vaccine containing Vibrio cholerae O1 (classical and El Tor) and O139, was administered in two doses with a 15-day interval during 7-31 August 2018, targeting around 180 000 people aged above 1 year in Cuamba District. Microplanning, community sensitisation, and training of local public health professionals and field enumerators were conducted. Feasibility and costs of vaccination were assessed using CholTool. Vaccination coverage and barriers were assessed through community surveys. RESULTS: The administrative coverage of the first and second rounds of the campaign were 98.9% (194 581) and 98.8% (194 325), respectively, based on the available population data that estimated total 196 652 inhabitants in the target area. The vaccination coverage survey exhibited 75.9% (±2.2%) and 68.5% (±3.3%) coverage for the first and second rounds, respectively. Overall, 60.4% (±3.4%) of the target population received full two doses of OCV. Barriers to vaccination included incompatibility between working hours and campaign time. No severe adverse events were notified. The total financial cost per dose delivered was US$0.60 without vaccine cost and US$1.98 including vaccine costs. CONCLUSION: The pre-emptive OCV mass vaccination campaign in remote setting in Mozambique was feasible with reasonable full-dose vaccination coverage to confer sufficient herd immunity for at least the next 3 to 5 years. The delivery cost estimate indicates that the OCV campaign is affordable as it is comparable with Gavi's operational support for vaccination campaigns.

Association between anticholinergic activity and xerostomia and/ or xerophthalmia in the elderly: systematic review.

PURPOSE: The aim of this work was to investigate the association between anticholinergic burden or anticholinergic drug use and xerostomia and/or xerophtalmia in elderly through a systematic review of the published literature. METHODS: A search was carried out in 3 databases (CINAHL, Embase and Pubmed). Studies conducted in people ≥65 years of age, who took anticholinergic medications, and measured the association between the anticholinergic burden or the use of these medications with the prevalence of xerostomia and / or xerophthalmia, published up to August 2022, were selected. Studies published in languages other than Spanish and/or English were excluded. RESULTS: One thousand two hundred eleven articles were identified, 10 were selected for this review: six cross-sectional studies, two cohorts, one case-control and one randomized controlled clinical trial. A total of 3535 patients included in the different studies were studied. The most used scales were the Anticholinergic Drug Scale (ADS) and the Anticholinergic Risk Scale (ARS). Four articles studied the relationship between the use of anticholinergic medication and the prevalence of xerostomia and / or xerophthalmia, finding a positive relationship with xerostomia in all of them. Another 6 measured the relationship between anticholinergic burden and xerostomia and / or xerophthalmia. Four found a positive relationship between anticholinergic burden and xerostomia and/or xerophthalmia. CONCLUSIONS: Our findings suggest a clear relationship between the use of anticholinergic drugs or anticholinergic burden and the presence of xerostomia. This relationship was less conclusive in the case of xerophthalmia.

Estado nutricional y uso de recursos sanitarios tras la implementación de un programa de nutrición enteral por sonda PEG para pacientes neurológicos con hospitalización domiciliaria / Nutritional status and use of health resources following the implementation of a PEG tube nutrition program for neurological patients in home hospitalization

Objetivo: el objetivo de este estudio es demostrar que la implantación de una nutrición enteral por sonda de gastrostomía por parte de la Unidad de Hospitalización a Domicilio (UHD) en pacientes afectos de enfermedades neurológicas que impiden su correcta nutrición, mejora significativamente su estado nutricional en términos de los parámetros tanto antropométricos como analíticos. Métodos: se recogieron datos de ingresos, días de estancia hospitalaria, visitas a Urgencias y parámetros nutricionales durante los 6 meses previos y los 6 meses posteriores a la colocación de una sonda de gastrostomía endoscópica percutánea (PEG) en 100 pacientes de la UHD del Hospital General Universitario de Elda (Alicante). Resultados: se incluyeron en el estudio un total de 100 pacientes neurológicos, el 58 % de ellos mujeres y con una edad media (desviación estándar, DE) de 78,3 (13,3) años, siendo el 60 % de los pacientes > 80 años. El seguimiento y tratamiento domiciliario de estos pacientes por parte de la UHD del Hospital General Universitario de Elda supuso una mejora de la calidad de vida y los parámetros nutricionales (peso, índice de masa corporal, proteínas, albúmina, prealbúmina, creatinina y hemoglobina), así como una disminución del número de complicaciones derivadas del manejo nutricional del paciente en su domicilio, y una importante reducción en el número de ingresos (90,27 %) y días de estancia hospitalaria (94,05 %), así como en el de visitas a los servicios de urgencias (79,47 %), con la consiguiente reducción de costes sanitarios. Conclusiones: la implantación de un programa de seguimiento domiciliario de pacientes portadores de PEG por una UHD mejora su estado nutricional y reduce los costes sanitarios generados (AU)

Objective: the objective of this study was to demonstrate that implementation of enteral nutrition by gastrostomy tube by the Home Hospitalization Unit (HHU) in patients suffering from neurological diseases, significantly improves their nutritional status, both in terms of anthropometric and analytical parameters. Methods: data on admissions, days of hospital stay, emergency room visits and nutritional parameters were collected during the 6 months before and 6 months after placement of a percutaneous endoscopic gastrostomy (PEG) tube in 100 patients from the UHD at General University Hospital in Elda (Alicante). Results: a total of 100 neurological patients were included in the study; 58 % of them were women and with a mean age (standard deviation, SD) of 78.3 (13.3) years, with 60 % of the patients being > 80 years. The monitoring and home treatment of these patients by the HHU of General University Hospital in Elda led to improvement in quality of life and nutritional parameters (weight, body mass index, proteins, albumin, prealbumin, creatinine, and hemoglobin), as well as a decrease in the number of complications derived from the nutritional management of patients at their home, and a significant reduction in number of admissions (90.27 %) and days of hospital stay (94.05 %), as well as of visits to emergency services (79.47 %), with a consequent reduction in healthcare costs. Conclusions: the implementation of a home-based monitoring program for patients with PEG by a HHU improves their nutritional status and reduces healthcare costs (AU)

Effect of the Melicoccus bijugatus leaf and fruit extracts and acidic solvents on the antimicrobial properties of chitosan-starch films.

AIM: Analysing the antimicrobial activity-against food-borne micro-organisms-of modified chitosan-starch films using formic and acetic acid as chitosan solvents and Melicoccus bijugatus leaves and fruit extracts. METHODS AND RESULTS: The films' antimicrobial activity against mesophilic aerobic bacteria, total coliform and fungi were also analysed, in accordance with the Mexican Official Norms (NOM-092-SSA1-1994, NOM-111-SSA1-1994 and NOM-113-SSA1-1994). The pH values of the films and extracts were measured, and the volatile compounds of the extracts and two films were determined by Gas Chromatography-Mass Spectrometry (GC-MS) considering the relationship among the type of compounds, extracts concentration, films' pH and the antimicrobial activity against bacteria and fungi. The best results are obtained by films with formic acid and 10% (v/v) of leaf and fruit extracts, in comparison with untreated chitosan-starch films. CONCLUSIONS: The extracts' compounds improved the films' antimicrobial capacity and inhibited the growth of micro-organisms with no previous sterilization required. It is correlated to the pH of the media, the combination of solvent/extract used and its concentration. SIGNIFICANCE AND IMPACT OF THE STUDY: This is one of the few researches where the antimicrobial activity of M. bijugatus extracts is studied. It was found that the presence of these extracts is capable of improving the antimicrobial activities of chitosan-starch films. The performance of the modified films suggests their potential application as novel food packaging materials and encourages further research.

The Mexican consensus on the detection and treatment of early gastric cancer. / Consenso mexicano sobre detección y tratamiento del cáncer gástrico incipiente.

Gastric cancer is one of the most frequent neoplasias in the digestive tract and is the result of premalignant lesion progression in the majority of cases. Opportune detection of those lesions is relevant, given that timely treatment offers the possibility of cure. There is no consensus in Mexico on the early detection of gastric cancer, and therefore, the Asociación Mexicana de Gastroenterología brought together a group of experts and produced the "Mexican consensus on the detection and treatment of early gastric cancer" to establish useful recommendations for the medical community. The Delphi methodology was employed, and 38 recommendations related to early gastric cancer were formulated. The consensus defines early gastric cancer as that which at diagnosis is limited to the mucosa and submucosa, irrespective of lymph node metástasis. In Mexico, as in other parts of the world, factors associated with early gastric cancer include Helicobacter pylori infection, a family history of the disease, smoking, and diet. Chromoendoscopy, magnification endoscopy, and equipment-based image-enhanced endoscopy are recommended for making the diagnosis, and accurate histopathologic diagnosis is invaluable for making therapeutic decisions. The endoscopic treatment of early gastric cancer, whether dissection or resection of the mucosa, should be preferred to surgical management, when similar oncologic cure results can be obtained. Endoscopic surveillance should be individualized.

Asthma app use and interest among patients with asthma: a multicenter study

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Respuesta: Comentarios sobre la herramienta web Anticholinergic Burden Calculator / Reply: Comments on the Anticholinergic Burden Calculator Web Tool

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Umbilical hernia repair with composite prosthesis: a single-centre experience.

PURPOSE: Since 2004, composite prosthesis repair is the preferred procedure for umbilical hernia repair in our centre, although long-term results of this technique are lacking. The aim of this study was to analyze the long-term results of a cohort of patients who underwent umbilical hernia repair with this procedure. METHODS: A retrospective cohort study of patients who underwent umbilical hernia repair with composite prosthesis was conducted. Data were obtained from electronic medical records. Univariate and multivariate analyses were performed to analyze the factors associated with postoperative complications and hernia recurrence. RESULTS: Between March 2004 and December 2015, 2135 patients underwent umbilical hernia repair and composite prosthesis (Ventralex or Ventralex ST®) was used in 1538 patients. 179 patients were lost during the follow-up. Finally, 1359 patients were included in the study. The prosthesis was placed in the preperitoneal space in 93.4% of the patients. 86.3% of the patients underwent same-day surgery. Only 2.1% of the patients developed a complication during the follow-up, and 1.8% of the patients required a new surgery. After a mean follow-up of 4.1 years, hernia recurrence rate was 3.9%. Multivariate analysis showed that hernia recurrence was associated with female gender, recurrent hernia, and postoperative complication. Postoperative complications were related to follow-up time and smoking patients. CONCLUSIONS: Long-term results after umbilical hernia repair with composite prosthesis are satisfactory, with a low percentage of complications and recurrences.

Consumo de bebidas energizantes en estudiantes universitarios / Consumption of energy drinks in university students

Las bebidas energizantes son productos que se consumen para reducir la sensación de cansancio y favorecer un estado activo, contienen principalmente cafeína, glucosa, glucoronolactona, taurina, guaraná vitaminas B1 (tiamina), vitamina B2 (riboflavina), vitamina B3 (niacina), vitamina B6 (piridoxina). El Objetivo de esta investigación fue determinar la frecuencia del consumo de las bebidas energizantes en los estudiantes de la Universidad Mayor Real y Pontificia de San Francisco Xavier de Chuquisaca y describir los posibles efectos adversos. Se trata de un estudio descriptivo, transversal, cuantitativo realizado en 367 estudiantes universitarios de las áreas de Salud, Económicas - Financieras, Sociales Humanidades, Tecnológicas y Agrarias. Para la recolección de datos se aplicó la encuesta. Entre los resultados se obtuvo que, del total de estudiantes encuestados, 69,21% si han consumido las bebidas energizantes, con una frecuencia de consumo de 2 a 3 veces por mes (39%), principalmente durante los parciales (18.80%) y después de realizar algún deporte (16.89%). Entre las marcas más consumidas de estas bebidas son red bull (30,25%) y power (14,99%).

Energy drinks are products that are consumed to reduce the feeling of tiredness and promote an active state, mainly contain caffeine, glucose, glucoronolactone, taurine, guarana B1 vitamins (thiamine), vitamin B2 (riboflavin), vitamin B3 (niacin), vitamin B6 (pyridoxine). The objective of this research was to determine the frequency of the consumption of energy drinks in the students of the Universidad Mayor Real and Pontificia de San Francisco Xavier de Chuquisaca and describe the possible adverse effects. This is a descriptive, cross-sectional, quantitative study conducted on 367 university students in the areas of health, economic - financial, social - humanities, technological and agricultural. The survey was applied to data collection. Among the results it was obtained that, of the total number of students surveyed, 69.21% if they have consumed the energy drinks, with a frequency of consumption of 2 to 3 times per month (39%), mainly during the partial ones (18.80%) and after performing some sport (16.89%). Among the most consumed brands of these drinks are red bull (30.25%) and power (14.99%).

Contrasting phylogeographic pattern among Eudyptes penguins around the Southern Ocean.

Since at least the middle-Miocene, the Antarctic Polar Front (APF) and the Subtropical Front (STF) appear to have been the main drivers of diversification of marine biota in the Southern Ocean. However, highly migratory marine birds and mammals challenge this paradigm and the importance of oceanographic barriers. Eudyptes penguins range from the Antarctic Peninsula to subantarctic islands and some of the southernmost subtropical islands. Because of recent diversification, the number of species remains uncertain. Here we analyze two mtDNA (HVRI, COI) and two nuclear (ODC, AK1) markers from 13 locations of five putative Eudyptes species: rockhopper (E. filholi, E. chrysocome, and E. moseleyi), macaroni (E. chrysolophus) and royal penguins (E. schlegeli). Our results show a strong phylogeographic structure among rockhopper penguins from South America, subantarctic and subtropical islands supporting the recognition of three separated species of rockhopper penguins. Although genetic divergence was neither observed among macaroni penguins from the Antarctic Peninsula and sub-Antarctic islands nor between macaroni and royal penguins, population genetic analyses revealed population genetic structure in both cases. We suggest that the APF and STF can act as barriers for these species. While the geographic distance between colonies might play a role, their impact/incidence on gene flow may vary between species and colonies.

Cyanobacteria inoculation enhances carbon sequestration in soil substrates used in dryland restoration.

Despite significant efforts to restore dryland ecosystems worldwide, the rate of success of restoration is extremely low in these areas. The role of cyanobacteria from soil biocrusts in reestablishing soil functions of degraded land has been highlighted in recent years. These organisms are capable of improving soil structure and promoting soil N and C fixation. Nevertheless, their application to restore functions of reconstructed soils in dryland restoration programs is yet to be harnessed. In this study, we used microcosms under laboratory conditions to analyse the effects of inoculating soil substrates used in post-mine restoration with a mixture of N-fixing cyanobacteria isolated from soil biocrust (Nostoc commune, Tolypothrix distorta and Scytonema hyalinum) on i) the recovery of the biocrust, and ii) the carbon sequestration and mineralisation rates of these substrates. Soils were collected from an active mine site in the mining-intensive biodiverse Pilbara region (north-west Western Australia) and consisted of previously stockpiled topsoil, overburden waste material, a mixture of both substrates, and a natural soil from an undisturbed area. Our results showed that cyanobacteria rapidly colonised the mine substrates, with biocrust coverage ranging from 23.8 to 52.2% and chlorophyll a concentrations of up to 12.2 µg g-1 three months after inoculation. Notably, soil organic C contents increased 3-fold (P < 0.001) in the mine waste substrate (from 0.6 g kg-1 to 1.9 g kg-1) during this period of time. Overall, our results showed that cyanobacteria inoculation can rapidly modify properties of reconstructed soil substrates, underpinning the potential key role of these organisms as bio-tools to initiate recovery of soil functions in infertile, reconstructed soil substrates.

Patients with advanced oral squamous cell carcinoma have high levels of soluble E-cadherin in the saliva.

BACKGROUND: The objective of this study was to assess the potential clinical value of the concentration of soluble salivary E-cadherin (sE-cadherin) compared with the clinical value of the presence of membranous E-cadherin (mE-cadherin) in oral squamous cell carcinoma tumor tissues. MATERIAL AND METHODS: Data regarding patient demographics, clinical stage, saliva and tumor tissue samples were collected. The saliva was analyzed for sE-cadherin protein levels and was compared to the mE-cadherin immunohistochemical expression levels in tumor tissues, which were assessed via the HercepTest® method. Patients without cancer were included in the study as a control group for comparisons of the sE-cadherin levels. RESULTS: sE-cadherin levels in the saliva of patients without cancer were lower than those in patients with cancer, and the difference was statistically significant (p=0.031). Low mE-cadherin expression was statistically significantly associated with lymph node positivity (p=0.015) and advanced clinical stage (p=0.001). The inverse relationship between mE-cadherin and sE-cadherin was significant in terms of lymph node positivity (p=0.014) and advanced clinical stage (p=0.037). CONCLUSIONS: The results suggest that sE-cadherin levels are significantly increased in patients with oral cancer and that its low expression within the membrane as well as the progression of the disease appear to be inversely associated with levels of sE-cadherin in the saliva.

[Vagus nerve stimulation: treatment of 158 pediatric patients with a long-term follow-up]. / Estimulador del nervio vago: tratamiento en 158 pacientes pediatricos con un largo seguimiento.

AIM: To describe a series of patients with drug resistant epilepsy treated with vagus nerve stimulation in a national pediatric hospital, evaluating efficacy, safety and tolerability. PATIENTS AND METHODS: A retrospective analysis of 158 pediatric patients with epilepsy resistant to pharmacological and non pharmacological treatment including surgery that were treated with vagus nerve stimulation between 2001-2015. Patients with progressive encephalopathies, and congenital heart disease were excluded. RESULTS: 158 patients (80 male) were included, with a mean age at implantation of 11.4 years and a mean age at evolution of epilepsy of 9.5 years. Time of follow-up: 1-15 years (median: 6.9 years). Patient's age at this time: 2-31 years (median: 14.1 years). Effectiveness: 66.5% of patients showed more or equal at 50% of seizure control at 24 months of implant. Just three patients showed severe side effects (1.8%). Minor side effects were seen in 26 patients (16.4%). Without side effects: 129 (81.8%). CONCLUSION: Vagus nerve stimulation is an effective, tolerable and safe therapy in our pediatric series with refractory epilepsy.

TITLE: Estimulador del nervio vago: tratamiento en 158 pacientes pediatricos con un largo seguimiento.Objetivo. Describir una poblacion pediatrica de pacientes con epilepsia farmacorresistente tratada con estimulador del nervio vago en un hospital nacional de pediatria, evaluando la eficacia, la tolerabilidad y la seguridad del tratamiento. Pacientes y metodos. Se realizo un analisis retrospectivo de 158 pacientes pediatricos seguidos por epilepsia refractaria al tratamiento farmacologico y no farmacologico, incluida la cirugia, que fueron tratados con estimulador del nervio vago entre los años 2001 y 2015. Se excluyeron pacientes con encefalopatias evolutivas y cardiopatias congenitas. Resultados. Se incluyeron 158 pacientes (80 varones) con una edad media de implante de 11,4 años y un tiempo de evolucion de epilepsia preimplante de 9,5 años. El tiempo de seguimiento fue de 1-15 años (mediana: 6,9 años); la edad actual de los pacientes, 2-31 años (mediana: 14,1 años). A los 24 meses postimplante, un 66,5% de los pacientes presento una mejoria mayor o igual al 50% de las crisis previas. Solo tres pacientes (1,8%) presentaron efectos adversos graves, 26 (16,4%) mostraron efectos adversos menores y 129 (81,8%) no mostraron efectos adversos al tratamiento. Conclusion. La terapia con estimulador del nervio vago en esta serie pediatrica con epilepsia refractaria fue eficaz, bien tolerada y segura.