Biosynthesis of Cytosporones in Leotiomycetous Filamentous Fungi.

Polyketides with the isochroman-3-one pharmacophore are rare among fungal natural products as their biosynthesis requires an unorthodox S-type aromatic ring cyclization. Genome mining uncovered a conserved gene cluster in select leotiomycetous fungi that encodes the biosynthesis of cytosporones, including isochroman-3-one congeners. Combinatorial biosynthesis in total biosynthetic and biocatalytic formats in Saccharomyces cerevisiae and in vitro reconstitution of key reactions with purified enzymes revealed how cytosporone structural and bioactivity diversity is generated. The S-type acyl dihydroxyphenylacetic acid (ADA) core of cytosporones is assembled by a collaborating polyketide synthase pair. Thioesterase domain-catalyzed transesterification releases ADA esters, some of which are known Nur77 modulators. Alternatively, hydrolytic release allows C6 hydroxylation by a flavin-dependent monooxygenase, yielding a trihydroxybenzene moiety. Reduction of the C9 carbonyl by a short chain dehydrogenase/reductase initiates isochroman-3-one formation, affording cytosporones with cytotoxic and antimicrobial activity. Enoyl di- or trihydroxyphenylacetic acids are generated as shunt products, while isocroman-3,4-diones are formed by autoxidation. The cytosporone pathway offers novel polyketide biosynthetic enzymes for combinatorial synthetic biology to advance the production of "unnatural" natural products for drug discovery.

Graft survival and delayed graft function with normothermic regional perfusion and rapid recovery after circulatory death in kidney transplantation: a propensity score matching study.

BACKGROUND: A shortage of kidney grafts has led to the implementation of various strategies, including donations after circulatory death. The in situ normothermic regional perfusion technique has been introduced to improve graft quality by reducing warm ischemia times. However, there is limited evidence available on its mid- and long-term outcomes. Therefore, this study aimed to compare the incidence of delayed graft function, graft function, and survival at three years among three groups: brain death donors, rapid recovery, and normothermic regional perfusion. METHODS: A retrospective analysis of a cohort of kidney transplantations was conducted at a single referral center between January 1, 2015, and December 31, 2019. Univariate and multivariate regression models and propensity score matching analysis were performed to compare recipient-related, transplantation procedure-related, donor-related, and kidney function variables. RESULTS: A total of 327 patients were included, with 256 kidneys from brain death donors, 52 kidneys from rapid recovery, and 19 patients from normothermic regional perfusion. After propensity score matching, univariate and multivariate analyses showed a higher incidence of delayed graft function in the rapid recovery group compared to the others (OR: 2.39 CI95%: 1.19, 4.77) with a longer hospital stay (median 11, 15 and 10 days, respectively). However, no differences in 1- and 3-year graft function and survival were found. CONCLUSIONS: Normothermic regional perfusion offers advantages over rapid recovery, with a reduced incidence of delayed graft function and a shorter hospital stay. However, no differences in mid-term graft function and survival were found.

Full Pulpotomy as a Treatment for Irreversible Pulpitis in Permanent Teeth: A Systematic Review of the Literature Based on Case Reports.

The objective of this systematic review was to evaluate the current evidence of case reports where the treatment for permanent teeth with a diagnosis of irreversible pulpitis was a full pulpotomy. This study was carried out by two reviewers following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A systematic electronic search was carried out in the PubMed, Google Scholar, and Scopus databases until the year 2022 to find articles in English where the treatment for irreversible pulpitis in permanent teeth was a full pulpotomy. Literature reviews, in vitro or animal studies, abstracts, and unpublished data were excluded. The intervention, control, and outcome parameters were selected following the "Population, Interventions, Control, and Outcome" (PICO) guidelines. A total of 636 articles were found, and 14 articles were selected to be included in this review. The selected articles describe cases of full pulpotomies in mature permanent teeth with a diagnosis of irreversible pulpitis with a total of 34 (100%) successful cases, where 18 were men and 16 were women, with an average age of 19.20 ± 10.59 years and an average follow-up of 35.82 ± 26.39 months, with 12 months being the minimum follow-up time. The material used most frequently for obturation of the full pulpotomy was mineral trioxide aggregate in 16 cases (47.06%). Within the limitations of this review, full pulpotomy presents a high success rate regardless of the tooth, age, or sex as a treatment for teeth diagnosed with irreversible pulpitis.

Kidney Survival Impact of Delayed Graft Function Depends on Kidney Donor Risk Index: A Single-Center Cohort Study.

BACKGROUND: Delayed graft function (DGF) is a significant challenge in renal transplantation, particularly with deceased donors, necessitating early postoperative dialysis. The prolonged effects of medium- and long-term DGF remain uncertain, marked by contradictory graft survival outcomes. This incongruity might arise from the inherent graft resilience and regenerative capacity during transplantation. This study investigates DGF's impact on graft survival, focusing on grafts displaying favorable (KDRI < 1) and unfavorable outcomes (KDRI ≥ 1). METHODS: In this retrospective cohort study (January 2015-December 2019), we assessed kidney transplants at our center, excluding multiorgan simultaneous cases, primary non-functioning grafts, and surgical complications causing graft loss. Patients were categorized into DGF presence or absence groups. Univariate and multivariate analyses, alongside propensity score matching (PSM), were performed. RESULTS: The study encompassed 322 deceased donor kidneys, with 83 encountering DGF. Grafts with higher KDRI indices (KDRI ≥ 1) and DGF exhibited a notably increased graft loss risk (HR: 4.17, 95% CI: 1.93-9.01). However, lower-KDRI donor grafts displayed no significant disparities between the DGF and non-DGF groups. CONCLUSIONS: Delayed graft function (DGF) development significantly contributes to graft loss in kidney transplants, particularly in grafts with KDRI ≥ 1.

Midterm Outcomes of Kidney Transplantation from Expanded Criteria Donors After Circulatory Death: A Single-Center Retrospective Cohort Study.

OBJECTIVES: Kidney transplant is the optimal treatment for end-stage renal disease; however, due to the imbalance between demand and supply, several strategies have been implemented to increase the donor pool. To increase the number of donors, expanded criteria donors after circulatory death have been explored as an acceptable graft source. In this study, we compared graft survival, estimated glomerular filtration rate at 3 and 5 years, and the incidence of delayed graft function between standard and expanded criteria donors after brain death and between standard and expanded criteria donors after circulatory death. MATERIALS AND METHODS: A prospective cohort study was conducted between January 1, 2015, and December 31, 2019, at Reina Sofia University Hospital. Variables related to the donor, recipient, and transplant procedure were analyzed, and univariate and multivariate logistic and Cox regression analyses were performed. RESULTS: Our study included 308 deceased donor kidneys. The kidneys from standard criteria brain dead donors had higher estimated glomerular filtration rate than the other groups (P < .03).However, no significant differences in estimated glomerular filtration rate were observed among the suboptimal groups (expanded criteria and standard criteria donors after brain death and expanded criteria donors after circulatory death). The incidence of delayed graft function was significantly higher in expanded criteria donors after circulatory death than in the other groups (odds ratio = 6.9; 95% CI, 2.22-21.71; P < .001). Nevertheless, we found no significant differences in death-censored graft loss among the groups. CONCLUSIONS: Kidney transplants from expanded criteria donors and donors after cardiac death are comparable, even when both criteria are combined. The use of expanded criteria donor kidneys after cardiac death is therefore a suitable approach to expand the donor pool, despite the higher risk of delayed graft function, as there were no significant differences in death-censored graft loss.

Relato de caso de intoxicación con superwarfarinas: un desafío terapéutico

La intoxicación humana por rodenticidas anticoagulantes de acción prolongada, conocidos como superwarfarinas, provoca coagulopatía de prolongado manejo. Presentamos el caso de un hombre de 42 años que ingirió una dosis tóxica de rodenticida en un intento suicida, evolucionando con epistaxis, INR de 11,6 y necesidad de hospitalización. Durante 7 días se realizaron controles seriados de pruebas de coagulación, con optimización de diferentes dosis de suplementación de Vitamina K. El caso destaca la potencia y vida media prolongada (aproximadamente 6 semanas) de este tipo de anticoagulantes, hecho que requiere un control clínico regular y una adherencia al tratamiento satisfactoria.

Human intoxication by long-acting anticoagulant rodenticides, known as superwarfarins, causes coagulopathy that is difficult to manage. We present the case of a 42-year-old man who ingested a toxic dose of rodenticide in a suicide attempt, evolving with epistaxis, INR of 11.6, and needing hospitalization. For seven days, serial controls of coagulation tests were carried out, with optimization of different doses of Vitamin K supplementation. The case highlights this type of anticoagulant's potency and prolonged half-life (approximately six weeks), which requires regular clinical control and satisfactory treatment adherence.

Serie de casos de COVID persistentes / Series of persistent Covid cases

Introducción: Sobre la etiopatogenia del COVID prolongado falta mucha evidencia, pero lo que sí parece claro es que aglutina a un colectivo heterogéneo de predominio autoinmune. Objetivos: Analizar la sintomatología de los pacientes con COVID -19 prolongado, relacionando los factores de riesgo y comorbilidades según la gravedad y el desarrollo de enfermedades autoinmunes. Material y Métodos: Se realizó un estudio de serie de casos, recogiéndose datos relativos a variables sociodemográficas, epidemiológicas y relativas al curso clínico de los casos mediante entrevista clínica telefónica y revisión de su historia clínica. Resultados: Se obtuvieron 4 casos, tenían una media de edad de 47,5 años, el 75% de los casos fue del sexo femenino, ninguno de los casos tenía como antecedente factores cardiovasculares, ni enfermedades autoinmunes. Conclusiones: Este estudio muestra que la mayoría de los pacientes descritos tienen un perfil autoinmune alterado que podría estar relacionada con la infección por SARS-CoV-2. (AU)

Introduction: Much evidence is lacking on the etiopathogenesis of prolonged COVID, but what does seem clear is that it brings together a heterogeneous group of predominantly autoimmune diseases. Objectives: Analyze the symptoms of patients with prolonged COVID-19, relating risk factors and comorbidities according to the severity and development of autoimmune diseases. Material and Methods: A case series study was carried out, collecting data related to sociodemographic and epidemiological variables and related to the clinical course of the cases through a clinical telephone interview and review of their clinical history. Results: 4 cases were obtained, they had a mean age of 47.5 years, 75% of the cases were female, none of the cases had a history of cardiovascular factors or autoimmune diseases. Conclusions: This study shows that most of the patients described have an altered autoimmune profile that could be related to SARS-CoV-2 infection. (AU)

Relación entre sobrepeso y obesidad con la progresión de la enfermedad renal crónica en pacientes del Centro Médico Naval en México / Association between overweight and obesity with the progression of chronic kidney disease in patients of Centro Médico Naval in Mexico

Introducción: La progresión de la enfermedad renal crónica podría estar asociada directa o indirectamente al sobrepeso y la obesidad; sin embargo, hasta el momento no hay evidencias suficientes para constatar esta relación. Objetivo: Determinar si el sobrepeso y obesidad son factores que contribuyen a una progresión más acelerada de la enfermedad renal crónica en una muestra de pacientes del Centro Médico Naval.Material y Método: A través de un estudio cuantitativo y observacional, de tipo comparativo, longitudinal y retrospectivo, se determinaron los cambios en el normopeso, sobrepeso y obesidad en 44 pacientes. La progresión de la enfermedad renal crónica se determinó con base en la tasa de filtración glomerular y niveles de albuminuria que presentaron estos pacientes. Los datos se recabaron con un instrumento de registro de diseño propio, durante un seguimiento de 3 años que se llevó a cabo de enero de 2019 a diciembre de 2021. Resultados: Los resultados muestran una tendencia al aumento en la progresión de la enfermedad renal crónica.Conclusiones: A pesar de que se encontró una tendencia al aumento, no se pudo probar una asociación estadísticamente significativa entre la obesidad y el sobrepeso con la progresión de esta enfermedad.(AU)

Introduction: The progression of chronic kidney disease could be directly or indirectly associated with overweight and obesity; however, until now there is not enough evidence to verify this association. Objective: To determine if overweight and obesity are factors that contribute to a more accelerated progression of chronic kidney disease in a sample of patients from the Centro Médico Naval. Material and Method: A comparative, longitudinal, and retrospective study was carried out. Changes in normal weight, overweight, and obesity were determined based on glomerular filtration rate and albuminuria levels presented by such patients. Data collection was performed using a custom-designed instrument during a 3-year follow-up from January 2019 to December 2021. Results: The results show an increasing trend in the progression of chronic kidney disease. Conclusions: Despite the increasing trend, a statistically significant association between overweight and obesity and the progression of this disease could not be proven.(AU)

Microstructure, Phase Evolution, and Chemical Behavior of CrCuFeNiTiAlx High Entropy Alloys Processed by Mechanical Alloying.

High entropy alloys (HEAs) of the type CrCuFeNiTi-Alx were processed through mechanical alloying. The aluminum concentration was varied in the alloy, to determine its effect on the HEAs' microstructure, phase formation, and chemical behavior. X-ray diffraction studies performed on the pressureless sintered samples revealed the presence of structures composed of face centered cubic (FCC) and body centered cubic (BCC) solid-solution phases. Since the valences of the elements that form the alloy are different, a nearly stoichiometric compound was obtained, increasing the final entropy of the alloy. The aluminum was partly responsible for this situation, which also favored transforming part of the FCC phase into BCC phase on the sintered bodies. X-ray diffraction also indicated the formation of different compounds with the alloy's metals. Bulk samples exhibited microstructures with different phases. The presence of these phases and the results of the chemical analyses revealed the formation of alloying elements that, in turn, formed a solid solution and, consequently, had a high entropy. From the corrosion tests, it could be concluded that the samples with a lower aluminum content were the most resistant to corrosion.

[Managing Superwarfarin Poisoning: A Challenging Case]. / Relato de caso de intoxicación con superwarfarinas: un desafío terapéutico.

Human intoxication by long-acting anticoagulant rodenticides, known as superwarfarins, causes coagulopathy that is difficult to manage. We present the case of a 42-year-old man who ingested a toxic dose of rodenticide in a suicide attempt, evolving with epistaxis, INR of 11.6, and needing hospitalization. For seven days, serial controls of coagulation tests were carried out, with optimization of different doses of Vitamin K supplementation. The case highlights this type of anticoagulant's potency and prolonged half-life (approximately six weeks), which requires regular clinical control and satisfactory treatment adherence.

Research Dynamics of Tissue Spheroids as Building Blocks: A Scientometric Analysis.

Tissue spheroids represent an innovative solution for tissue engineering and regenerative medicine. They constitute an in vitro three-dimensional cell culture model capable of mimicking the complex composition of a native tissue on a micro-scale; this model can function as a building block and be assembled into larger tissue constructs. Due to the potential tissue spheroids have for the evolution of the health industry, there is a need to assess the research dynamics of this field. Thus far, there have been no studies on their use as building blocks. To fill this gap, a study was performed to characterize the evolution of research where tissue spheroids were used as building blocks to generate tissue constructs. A scientometric analysis of the literature regarding tissue spheroid technologies was developed by quantification of bibliometric performance indicators. For this purpose, articles published during the period January 1, 2015 - December 31, 2021, from the Scopus database were organized and analyzed. The main subject areas, countries, cities, journals, institutions, and top-cited articles as well as the types of techniques, cells, culture time, and principal applications were identified. This research supports the definition and growth of research and development strategies for new technologies such as tissue spheroids.

Thermoregulatory Response of Blackbelly Adult Ewes and Female Lambs during the Summer under Tropical Conditions in Southern Mexico.

High environmental temperatures cause heat stress in ewes, resulting in thermoregulatory problems. In this study, the thermoregulatory responses of Blackbelly adult ewes (G1, n = 14) and female lambs (G2, n = 7), during the summer under tropical conditions, in southern Mexico were analyzed. Different physiological variables and skin temperatures (ST) of the ewes were recorded. Breathing frequency (BF) values were similar between groups at 116.73 ± 33.598 bpm (G1) and 113.661 ± 34.515 bpm (G2) (p > 0.05). In the case of skin elasticity (SE), there were no significant differences between the time of day and the age of the ewes (p > 0.05). Significant differences were observed between groups for BF, rectal temperature (RT), and heart rate (HR) values (p < 0.05). All ST values, for both groups, were significantly higher during the afternoon (p < 0.001). In general, all Blackbelly adult ewes and female lambs during the summer present severe heat stress conditions as a result of an increase in physiological constants and ST. It is concluded that all ewes thermoregulate body temperature by modifying different physiological variables to counteract the effect of heat stress.

Safety and efficacy of pilocarpine, cevimeline, and diquafosol compared to artificial tears for the treatment of dry eye: protocol for a systematic review.

BACKGROUND: Dry eye disease (DED) is a condition that compromises the ocular surface and affects millions of people around the world. In recent years, a scheme has been proposed for the treatment of DED, with the use of artificial tear being the mainstay of treatment. In this scheme, the use of secretagogues is suggested as part of the treatment for patients with moderate to severe affectation. With this systematic review, we aim to evaluate the effectiveness and safety of secretagogues for DED. METHODS: Electronic databases will be searched; we will include randomized controlled trials that compare secretagogues and artificial tears. Study inclusion will not be restricted on the basis of language or publication status. We will use Google Translate to assess studies written in languages other than English and Spanish. Identification, evaluation, data extraction, and assessment of risk of bias will be conducted by two authors of the review, a third review author will resolve any disagreement. The outcomes will be the ocular surface disease index score, tear film break-up time, Schirmer test score, VRQoL Score, and tear film osmolarity. We will use the Cochrane Collaboration Risk of Bias 2 (RoB 2) tool for assessing the risk of bias of the included studies. Based on the heterogeneity of the included studies, we will combine the findings in a meta-analysis using a fixed effect model if heterogeneity ≤ 50% or a random effect model if heterogeneity > 50%. If we deem meta-analysis as inappropriate, we will document the reasons and report findings from the individual studies narratively. DISCUSSION: Based on the evidence obtained, we will evaluate the effect of pilocarpine, cevimeline, and diquafosol and compare it to artificial tears on multiple outcome measures. This systematic review aims to determine the efficacy and safety of the secretagogues pilocarpine, cevimeline, and diquafosol to help clinicians in the decision-making process. TRIAL REGISTRATION: PROSPERO CRD42020218407 .

Chest Radiograph Severity and Its Association With Outcomes in Subjects With COVID-19 Presenting to the Emergency Department.

BACKGROUND: Severity of radiographic abnormalities on chest radiograph in subjects with COVID-19 has been shown to be associated with worse outcomes, but studies are limited by different scoring systems, sample size, subject age, and study duration. Data regarding the longitudinal evolution of radiographic abnormalities and its association with outcomes are scarce. We sought to evaluate these questions using a well-validated scoring system (the Radiographic Assessment of Lung Edema [RALE] score) using data over 6 months from a large, multihospital health care system. METHODS: We collected clinical and demographic data and quantified radiographic edema on chest radiograph obtained in the emergency department (ED) as well as on days 1-2 and 3-5 (in those admitted) in subjects with a nasopharyngeal swab positive for SARS-CoV-2 by polymerase chain reaction (PCR) visiting the ED for coronavirus disease 2019 (COVID)-19-related complaints between March-September 2020. We examined the association of baseline and longitudinal evolution of radiographic edema with severity of hypoxemia and clinical outcomes. RESULTS: Eight hundred and seventy subjects were included (median age 53.6; 50.8% female). Inter-rate agreement for RALE scores was excellent (interclass correlation coefficient 0.84 [95% CI 0.82-0.87], P < .001). RALE scores correlated with hypoxemia as quantified by SpO2 /FIO2 (r = -0.42, P < .001). Admitted subjects had higher RALE scores than those discharged (6 [2-11] vs 0 [0-3], P < .001). An increase of RALE score ≥ 4 was associated with worse 30-d survival (P = .006). Larger increases in the RALE score were associated with worse survival. CONCLUSIONS: The RALE score was reproducible and easily implementable in adult subjects presenting to the ED with COVID-19. Its association with physiologic parameters and outcomes at baseline and longitudinally makes it a readily available tool for prognostication and early ICU triage, particularly in patients with worsening radiographic edema.

Association between brain natriuretic peptide and cardiac dysfunction in hypertensive pregnancy disorders.

OBJECTIVE: The aim of this work is to identify the correlation between serum brain natriuretic peptide (BNP) and left ventricle (LV) systolic and diastolic function in hypertensive pregnancy disorders (HPD) through echocardiographic parameters. STUDY DESIGN: Eighty-seven pregnant patients were included, 23 with normotensive pregnancy (NP), 28 with gestational hypertension (GH) and 36 with preeclampsia (PE). Conventional 2D echocardiography was used to evaluate systolic and diastolic function such as E/a, E/e', LV mass index, LV ejection fraction, as well as left atria (LA) diameters, LA indexed volume, LV strain and LA strain (LAS). Brain natriuretic levels (BNP) blood levels were also determined. MAIN OUTCOME MEASURES: The serum levels of BNP were higher in patients with PE [median (interquartile range, IQR)] 189 (142-215) pg/ml and GH 105 (46-162) pg/ml compared to NP 23 (9-33) pg/ml, (p = 0.001). BNP levels had a negative correlation with LAS (Rho = -0.79, p < 0.001). Preeclampsia patients had lower LAS [median (IQR)] 22% (20%-24%) compared to the GH group 23% (20%-24%) and NP 35% (34% -35%), p = 0.001. Classification and Regression Trees multivariate analysis found patterns that define trends to form mutually excluding homogeneous groups such as: a) First parameter that separates 2 groups is septal e > 8.2 or < 8.2b), BNP serum levels above 89 pg/ml, and c) LAS increases the discriminatory performance to detect and define the diastolic dysfunction or not. CONCLUSIONS: At least one third of women with HPD had moderate diastolic dysfunction. The degree of diastolic dysfunction was negatively correlated with serum BNP levels and severity of HPD. LAS increase discriminatory performance to identify diastolic dysfunction in HPD.

Reliability and usefulness of maximum soccer-specific jump test: a valid and cost-effective system to measure on soccer field.

The aims of this study were (a) to assess intra-session reliability and usefulness of the soccer-specific maximum vertical jump (heading test, HT) and (b) to analyse the validity of the easy-to-use and cost-effective instrument (smartphone camera, MOB) compared with gold-standard instrument (3D motion capture system, MOCAP) to obtain the vertical jump performance during HT. Twelve semi-professional high-level and fifteen amateur soccer male players (23.9 ± 3.6 years) performed three HT attempts, and kinematic data were recorded with MOB and MOCAP. Intra-class correlation coefficient (ICC) and coefficient of variation (CV) were used as measures of intra-session reliability. T-test with Cohen's effect size (ES), Pearson's product moment and Bland-Altman analysis were used to obtain MOB validity. Regarding intra-session reliability, the CV was 1.13%, and ICC was 0.98, considered acceptable. Respecting validity criteria did not reveal significant differences (p < 0.05; effect size = 0.06, considered trivial), 'almost perfect' correlation (Pearson) (r = 0.98; p < 0.05), and strong agreement were obtained between MOB and MOCAP. This finding showed a test (HT) with a specific character, using cost-effective instrument and applicable to all soccer fields (adjusted to the standardised lines in the soccer field), all of them backed-up by reliability, usefulness and validity criteria.

Microstructure, corrosion rate, and mechanical properties of unidirectionally and cross-rolled Mg-0.375Ga and Mg-0.750Ga alloys.

The effect of unidirectional and cross rolling on the corrosion rate, texture, tensile properties and hemolysis of the Mg-0.375Ga and Mg-0.750Ga alloys was evaluated. Pure Mg and as-cast alloys were processed by unidirectional and cross rolling at 400°C to obtain a total thickness reduction of 50%. The corrosion rate was measured by the weight loss method in simulated body fluid. Determination of the hemolysis percentage was carried out by direct contact of specimens with diluted blood. After hot rolling, the mechanical properties of the alloys were improved. The cross-rolled Mg-0.750Ga alloy showed the highest grain refinement (55 µm) and the highest ultimate tensile strength (240 MPa), however, lower elongation (13.9%) than the rolled Mg-0.375Ga alloy. While unidirectional rolling creates a strong basal texture, cross rolling weakens considerably this texture. The Ga addition weakens the basal texture. Corrosion rate of the Mg-Ga alloys was significantly reduced (<1 mm/yr) after heat treatment and hot rolling due the homogenization of the microstructure and the presence of gallium as alloying element. The cross-rolled samples showed higher corrosion than the heat-treated and unidirectionally rolled samples. After rolling, alloys showed hemolysis percentages between 7.1 and 9.3%, values lower than those presented by pure magnesium (>22.7%) and as-cast alloys (>24.2%); however, the alloys are still hemolytic (>5%).

The Promotion of Values in Young People in Different Contexts of Sports Practice / La Promoción de Valores en los Jóvenes en los Diferentes Contextos de la Práctica Deportiva

The educational potential of sport is a wide-ly researched topic area in sports science. This potential is greater or lesser depending on the focus given to sports. The objectives of this study are to: (i) Establish the reference values and their hierarchy in participants in the RMF’s Socio-sporting Basketball Schools compared with secondary school students; (ii) Identify whether there are differences according to sex and age group; (iii) To determine if there are differences in the relationships between dimensions comparing the RMF athletes and the group of secondary school students. The study includes 304 participants. Of these, 80 have engaged in sports at the RMF’s Socio-sporting Basketball Schools and 224 are secondary school students who had not played sports in the RMF’s schools. All participants are aged between 12 and 16 (M = 13.94; SD = 1.35). The instrument used is the Questionnaire on Values in Team Sports, in Spanish Cuestionario sobre Valores en los Deportes de Equipo (CUVADE) (12-16 years). This tool allows the researcher to establish the reference values of participants in team sports as well as the hierarchy in which they place these values, both inside and outside the educational and/or sports club setting. The athletes at the RMF Socio-sporting Schools exhibit a greater appreciation of the dimensions of sportsmanship, fair play, and peaceful behaviour. In addition, the boys and girls who play basketball at the RMF Socio-sporting Schools do not display significant differences in any of the six dimensions. However, the secondary school students display differences in the dimensions of personal and team success. According to the data obtained, the sporting-educational model of the RMF can be regarded as contributing to young athletes’ optimal personal development.(AU)

Pancreatitis aguda necrotizante infectada. Desbridamiento retroperitoneal video asistido / Infected necrotizing pancreatitis. Video-assisted retroperitoneal debridement

Resumen El tratamiento escalonado de la pancreatitis aguda necrotizante infectada consiste en el uso de antibióticos de amplio espectro, drenaje y necrosectomía mínimamente invasiva, si fuese necesaria. Esto ha reemplazado a la cirugía abierta como el estándar de tratamiento. El desbridamiento retroperitoneal video asistido (VARD), es una forma de necrosectomía quirúrgica mínimamente invasiva. Presentamos una serie de 5 casos (2 mujeres y 3 varones) con pancreatitis aguda grave y necrosis pancreática infectada tratados de forma escalonada y VARD. El rango de edad fue de 27 a 60 años. Todos los pacientes tuvieron pancreatitis de etiología biliar. El rango del APACHE II fue de 16 a 20. El rango del tiempo para el drenaje percutáneo lumbar fue de 4 a 7 semanas. Hubo una complicación del drenaje percutáneo (fistula duodenal) que se resolvió con tratamiento médico. Los cultivos de todas las necrosis fueron positivos. El tiempo para la realización del VARD tuvo un rango de 6 a 10 semanas. Un paciente requirió dos procedimientos. Hubo dos fístulas pancreáticas tipo B asociadas al VARD, que se trataron conservadoramente. No hubo mortalidad. A largo plazo, dos pacientes fueron diagnosticados de insuficiencia pancreática exocrina y endocrina. Concluimos que en los pacientes con necrosis pancreática infectada que requieran desbridamiento, el VARD es una alternativa segura, efectiva y con buenos resultados a largo plazo.

Abstract The step-up approach for infected necrotizing pancreatitis, consisting of broad-spectrum antibiotics, drainage followed, if necessary, by minimally invasive necrosectomy, has replaced open surgery as the standard of management. Video-assisted retroperitoneal debridement (VARD) is a surgical minimally invasive necrosectomy. This is a 5 cases series (2 female and 3 males) with severe acute pancreatitis and infected pancreatic necrosis who underwent step up approach and VARD. The age ranged from 27 to 60 years old. Al patients had biliary pancreatitis. APACHE II ranged from 16 to 20. The time to percutaneous lumbar drainage ranged from 4 to 7 weeks. There was one complication associated with percutaneous drainage (duodenal fistula) with nonoperative management. All necrotizing pancreatitis had positive cultures. The time to perform VARD ranged from 6 to 10 weeks. One patient required two procedures. There were two type B pancreatic fistulas associated with VARD, managed nonoperatively. There was no mortality. During long-term follow-up two patients were diagnosed with exocrine and endocrine pancreatic insufficiency. We conclude that VARD is a safe and effective procedure in patients with infected necrotizing pancreatitis requiring debridement, and with good long-term outcomes.