The Impact of Polyphosphates on the Colloidal Stability of Laponite Particles.

The effect of polyphosphate (polyP) adsorption on the colloidal properties of disc-shaped laponite (LRD) particles was examined in aqueous dispersions with a focus on elucidating the interparticle forces that govern the colloidal stability of the systems. The charge and aggregation rate data of bare LRD exhibited an ionic strength-dependent trend, confirming the presence of double-layer repulsion and van der Waals attraction as major surface interactions. The charge of LRD particles significantly increased in magnitude at elevated polyP concentrations as a result of polyP adsorption and subsequent overcharging of the positively charged sites on the edges of the LRD discs. A transition from stable to unstable LRD colloids was observed with increasing polyP doses indicating the formation of aggregates in the latter systems due to depletion forces and/or bridging interactions induced by dissolved or adsorbed polyP, respectively. The degree of phosphate polymerization influenced neither the charge nor the aggregation mechanism. The findings clearly confirm that polyP adsorption was the driving phenomenon to induce particle aggregation in contrast to other clay types, where phosphate derivatives act as dispersion stabilizing agents. This study provides valuable insights into the early stages of aggregation in colloidal systems involving LRD and polyPs, which have a crucial role in predicting further material properties that are important to designing LRD-polyP composites for applications such as potential phosphate sources in chemical fertilizers.

Enhanced Timeliness and Co-Administration of Meningitis B Vaccination in Children: Impact of Funding in Valencian Community, Spain.

Public funding of vaccines may enhance vaccination rates, co-administration, and timeliness. The impacts of including the serogroup B meningococcus vaccine (MenB) into the national immunisation schedule on vaccination rates, co-administration rates, and timeliness were assessed using a population-based pre-funding (2022) and post-funding (2023) study design. MenB vaccination rates improved after funding and were in line with previously funded vaccines. Co-administration rates also increased significantly. Timely administration increased, protecting children at an early age. Public funding has a positive impact on vaccine accessibility and early protection. Consistent population characteristics highlight the role of funding.

Effectiveness of nirsevimab introduction against respiratory syncytial virus in the Valencian Community: A preliminary assessment.

Respiratory syncytial virus (RSV) represents a high burden of disease in children and the primary cause of hospitalization, especially in children under 1 year old. In the Valencian Community (Spain), nirsevimab, a long-acting monoclonal antibody, was introduced for the RSV 2023-2024 season as a universal pre-exposure prophylaxis for high-risk children and those under 6 months old. This study examines its impact, coverage, and effectiveness. The campaign achieved 88.5 % coverage and 73.7 % of effectiveness. Analysis of over 27,000 susceptible children (over 24,000 immunized), showed that those immunized exhibited a threefold reduction in RSV incidence compared to non-immunized ones. To prevent one case, the number needed to immunize (NNI) was 63. Hospitalizations due to acute respiratory infections were almost two times lower in immunized children compared to non-immunized ones (0.9 % vs 1.6 %, respectively). These first results showcase the preliminary positive impact of this public health intervention.

Mesentery-Sparing Technique: a New Intracorporeal Approach for Urinary Diversion in Robot-Assisted Radical Cystectomy.

BACKGROUND: Robotic-assisted radical cystectomy (RARC) with intracorporeal urinary diversion (ICUD) is associated with significant morbidity and mortality. We present an alternative technique that preserves the complete mesenteric vascularization during the isolation of the intestinal segment used in ICUD, including distal vessels. This approach aims to minimize the risk of ischemia in both the ileal anastomosis and the isolated loop at the diversion site. METHODS: This cohort study included 31 patients, both male and female, who underwent RARC with ICUD from February 2018 to November 2023, performed by a single surgeon. Intraoperative and postoperative complications data were retrieved for analysis, employing our proposed mesentery-sparing technique in all cases. The primary endpoint was the incidence of intraoperative and postoperative complications directly attributable to the mesentery-sparing approach in ICUD. Secondary endpoints included other postoperative variables not directly related to mesentery preservation, such as the incidence of postoperative ileus requiring parenteral nutrition and the duration of hospitalization. RESULTS: None of the patients experienced intraoperative or postoperative complications directly related to mesentery-sparing, such as intestinal fistulae or internal hernias. The median duration of hospitalization was 6 days, and postoperative ileus necessitating total parenteral nutrition occurred in 19% of the patients. Minor complications (Clavien-Dindo grades I-II) accounted for 27.6% of the cases and major complications (grades III-V) accounted for 20.6%. CONCLUSION: The mesentery-sparing technique outlined herein offers an alternative method for preserving the vascularization of intestinal segments and reducing the risk of intestinal complications in ICUD during RARC.

Dopamine D2 receptor antagonist counteracts hyperglycemia and insulin resistance in diet-induced obese male mice.

Obesity leads to insulin resistance (IR) and type 2 diabetes. In humans, low levels of the hormone prolactin (PRL) correlate with IR, adipose tissue (AT) dysfunction, and increased prevalence of T2D. In obese rats, PRL treatment promotes insulin sensitivity and reduces visceral AT adipocyte hypertrophy. Here, we tested whether elevating PRL levels with the prokinetic and antipsychotic drug sulpiride, an antagonist of dopamine D2 receptors, improves metabolism in high fat diet (HFD)-induced obese male mice. Sulpiride treatment (30 days) reduced hyperglycemia, IR, and the serum and pancreatic levels of triglycerides in obese mice, reduced visceral and subcutaneous AT adipocyte hypertrophy, normalized markers of visceral AT function (PRL receptor, Glut4, insulin receptor and Hif-1α), and increased glycogen stores in skeletal muscle. However, the effects of sulpiride reducing hyperglycemia were also observed in obese prolactin receptor null mice. We conclude that sulpiride reduces obesity-induced hyperglycemia by mechanisms that are independent of prolactin/prolactin receptor activity. These findings support the therapeutic potential of sulpiride against metabolic dysfunction in obesity.

Robotic versus laparoscopic gastrectomy for gastric cancer: A Western propensity score matched analysis.

BACKGROUND: Robot-assisted gastrectomy (RG) has been shown to be safe and feasible in the treatment of gastric cancer (GC). However, it is unclear whether RG is equivalent to laparoscopic gastrectomy (LG), especially in the Western world. Our objective was to compare the outcomes of RG and LG in GC patients. METHODS: We reviewed all gastric adenocarcinoma patients who underwent curative gastrectomy by minimally invasive approach in our institution from 2009 to 2022. Propensity score matching (PSM) analysis was conducted to reduce selection bias. DaVinci Si platform was used for RG. RESULTS: A total of 156 patients were eligible for inclusion (48 RG and 108 LG). Total gastrectomy was performed in 21.3% and 25% of cases in LG and RG, respectively. The frequency of stage pTNM II/III was 48.1%, and 54.2% in the LG and RG groups (p = 0.488). After PSM, 48 patients were matched in each group. LG and RG had a similar number of dissected lymph nodes (p = 0.759), operative time (p = 0.421), and hospital stay (p = 0.353). Blood loss was lower in the RG group (p = 0.042). The major postoperative complications rate was 16.7% for LG and 6.2% for RG (p = 0.109). The 30-day mortality rate was 2.1% and 0% for LG and RG, respectively (p = 1.0). There was no significant difference between the LG and RG groups for disease-free survival (79.6% vs. 61.2%, respectively; p = 0.155) and overall survival (75.9% vs. 65.7%, respectively; p = 0.422). CONCLUSION: RG had similar surgical and long-term outcomes compared to LG, with less blood loss observed in RG.

Early estimates of nirsevimab immunoprophylaxis effectiveness against hospital admission for respiratory syncytial virus lower respiratory tract infections in infants, Spain, October 2023 to January 2024.

The monoclonal antibody nirsevimab was at least 70% effective in preventing hospitalisations in infants with lower respiratory tract infections (LRTI) positive for respiratory syncytial virus (RSV) in Spain (Oct 2023-Jan 2024), where a universal immunisation programme began late September (coverage range: 79-99%). High protection was confirmed by two methodological designs (screening and test-negative) in a multicentre active surveillance in nine hospitals in three regions. No protection against RSV-negative LRTI-hospitalisations was shown. These interim results could guide public-health decision-making.

Factors associated with disease progression in patients with atrial fibrillation and heart failure anticoagulated with rivaroxaban.

BACKGROUND: Patients with atrial fibrillation (AF) and heart failure (HF) have a high risk of thromboembolism and other outcomes and anticoagulation is recommended. HYPOTHESIS: This study was aimed to explore the risk factors associated with HF worsening in patients with AF and HF taking rivaroxaban in Spain. METHODS: Multicenter, prospective, observational study that included adults with AF and chronic HF, receiving rivaroxaban ≥4 months before entering. HF worsening was defined as first hospitalization or emergency visit because of HF exacerbation. RESULTS: A total of 672 patients from 71 Spanish centers were recruited, of whom 658 (97.9%) were included in the safety analysis and 552 (82.1%) in the per protocol analysis. At baseline, mean age was 73.7 ± 10.9 years, 64.9% were male, CHA2 DS2 -VASc was 4.1 ± 1.5, HAS-BLED was 1.6 ± 0.9% and 51.3% had HF with preserved ejection fraction. After 24 months of follow-up, 24.9% of patients developed HF worsening, 11.6% died, 2.9% had a thromboembolic event, 3.1% a major bleeding, 0.5% an intracranial bleeding and no patient had a fatal hemorrhage. Older age, the history of chronic obstructive pulmonary disease, the previous use of vitamin K antagonists, and restrictive or infiltrative cardiomyopathies, were independently associated with HF worsening. Only 6.9% of patients permanently discontinued rivaroxaban treatment. CONCLUSIONS: Approximately one out of four patients with HF and AF treated with rivaroxaban developed a HF worsening episode after 2 years of follow-up. The identification of those factors that increase the risk of HF worsening could be helpful in the comprehensive management of this population.

Vasoinhibin's Apoptotic, Inflammatory, and Fibrinolytic Actions Are in a Motif Different From Its Antiangiogenic HGR Motif.

Vasoinhibin, a proteolytic fragment of the hormone prolactin, inhibits blood vessel growth (angiogenesis) and permeability, stimulates the apoptosis and inflammation of endothelial cells, and promotes fibrinolysis. The antiangiogenic and antivasopermeability properties of vasoinhibin were recently traced to the HGR motif located in residues 46 to 48 (H46-G47-R48), allowing the development of potent, orally active, HGR-containing vasoinhibin analogues for therapeutic use against angiogenesis-dependent diseases. However, whether the HGR motif is also responsible for the apoptotic, inflammatory, and fibrinolytic properties of vasoinhibin has not been addressed. Here, we report that HGR-containing analogues are devoid of these properties. Instead, the incubation of human umbilical vein endothelial cells with oligopeptides containing the sequence HNLSSEM, corresponding to residues 30 to 36 of vasoinhibin, induced apoptosis, nuclear translocation of NF-κB, expression of genes encoding leukocyte adhesion molecules (VCAM1 and ICAM1) and proinflammatory cytokines (IL1B, IL6, and TNF), and adhesion of peripheral blood leukocytes. Also, intravenous or intra-articular injection of HNLSSEM-containing oligopeptides induced the expression of Vcam1, Icam1, Il1b, Il6, and Tnf in the lung, liver, kidney, eye, and joints of mice and, like vasoinhibin, these oligopeptides promoted the lysis of plasma fibrin clots by binding to plasminogen activator inhibitor-1 (PAI-1). Moreover, the inhibition of PAI-1, urokinase plasminogen activator receptor, or NF-κB prevented the apoptotic and inflammatory actions. In conclusion, the functional properties of vasoinhibin are segregated into 2 different structural determinants. Because apoptotic, inflammatory, and fibrinolytic actions may be undesirable for antiangiogenic therapy, HGR-containing vasoinhibin analogues stand as selective and safe agents for targeting pathological angiogenesis.

Prolactin Inhibits or Stimulates the Inflammatory Response of Joint Tissues in a Cytokine-dependent Manner.

The close association between rheumatoid arthritis (RA), sex, reproductive state, and stress has long linked prolactin (PRL) to disease progression. PRL has both proinflammatory and anti-inflammatory outcomes in RA, but responsible mechanisms are not understood. Here, we show that PRL modifies in an opposite manner the proinflammatory actions of IL-1ß and TNF-α in mouse synovial fibroblasts in culture. Both IL-1ß and TNF-α upregulated the metabolic activity and the expression of proinflammatory factors (Il1b, Inos, and Il6) via the activation of the nuclear factor-κB (NF-κB) signaling pathway. However, IL-1ß increased and TNF-α decreased the levels of the long PRL receptor isoform in association with dual actions of PRL on synovial fibroblast inflammatory response. PRL reduced the proinflammatory effect and activation of NF-κB by IL-1ß but increased TNF-α-induced inflammation and NF-κB signaling. The double-faceted role of PRL against the 2 cytokines manifested also in vivo. IL-1ß or TNF-α with or without PRL were injected into the knee joints of healthy mice, and joint inflammation was monitored after 24 hours. IL-1ß and TNF-α increased the joint expression of proinflammatory factors and the infiltration of immune cells. PRL prevented the actions of IL-1ß but was either inactive or further increased the proinflammatory effect of TNF-α. We conclude that PRL exerts opposite actions on joint inflammation in males and females that depend on specific proinflammatory cytokines, the level of the PRL receptor, and the activation of NF-κB signaling. Dual actions of PRL may help balance joint inflammation in RA and provide insights for development of new treatments.

Effects of Larrea nitida nanodispersions on the growth inhibition of phytopathogens.

Larrea nitida Cav. (Zygophyllaceae) is a plant endemic to Argentina and Chile, and its extract has been studied over the last years due to the presence of antimicrobial agents that can be used to control the growth of some pathogens in agriculture. However, the extract is highly hydrophobic, which strongly affects its fungicidal activity in aqueous media. In this sense, the solid dispersion technique was used to produce L. nitida extract nanodispersions with polyethylene glycol (PLE) and with polyethylene glycol and zinc acetate (PZLE). In order to further evaluate the activity of the extract in PLE and PZLE, blank nanodispersions containing only polyethylene glycol (PEG) and zinc acetate (PZ) without the addition of the extract were also produced. The fungicidal activity of the water-soluble nanoparticles was evaluated at different concentrations (0.037-0.110 g.mL-1). In general, the nanoparticles were successfully produced on a nanometric size and presented a significant inhibitory activity on the growth of the pathogens Fusarium oxysporum and Fusarium verticillioides in aqueous media. Compared to PLE, PZLE presented increased fungistatic activity, possibly due to their increased solubility in water. Even though their application in agriculture should be further investigated, the nanodispersions present great potential to be applied as a green biotechnological tool.

Patient's safety and satisfaction on same day discharge after robotic and laparoscopic radical prostatectomy versus discharge after 24 or 48 h: a longitudinal randomized prospective study.

BACKGROUND: There is a tendency of prompted global health systems to reduce the length of hospital stay without compromising patient safety or satisfaction. We evaluated the safety and viability of early discharge in patients undergoing minimally invasive radical prostatectomy (MIRP), as well as patient satisfaction with this strategy. METHODS: This longitudinal prospective study included 72 patients who underwent MIRP for prostate cancer. Three groups were performed according to the day of hospital discharge following surgery: same day (G1), first day after (G2), and second day after (G3). Satisfaction, adverse events, and readmission were analyzed for each group. Associations between clinicopathologic variables and same-day discharge were analyzed by comparing data between G1 patients who did and did not achieve same-day discharge. RESULTS: 16.7% of patients were not discharged according to randomization (10 randomized to G1). 80% of G1 patients who did not achieve same-day discharge had Gleason scores of 3 + 4 or 4 + 3, which were observed in 35.7% of patients discharged on the same day (P < 0.05). Average prostate weight was significantly lower in patients who achieved same-day discharge than in those who did not (P < 0.01). Univariable logistic regression points to Gleason scores of 3 + 4 or 4 + 3 as the main factors associated with unsuccessful same-day discharge (P < 0.05). There were no significant differences in satisfaction scores. CONCLUSIONS: Same-day discharge was both safe and feasible and does not appear to affect satisfaction in a subset of patients with prostate cancer. Surgeons should consider the Gleason score when determining whether same-day discharge is appropriate.

Outcomes and factors associated with mortality in patients with atrial fibrillation and heart failure: FARAONIC study.

BACKGROUND: Heart failure (HF) and atrial fibrillation (AF) are common and coexistent conditions. HYPOTHESIS: To investigate the adverse events and mortality risk factors in patients with AF and HF treated with rivaroxaban in Spain. METHODS: Multicenter, prospective and observational study with a follow-up of 2 years, that included adults, with a diagnosis of nonvalvular AF and chronic HF, anticoagulated with rivaroxaban at least 4 months before being enrolled. RESULTS: A total of 672 patients from 71 Spanish centers were recruited, of whom 658 (97.9%) were included in the safety analysis and 552 (82.1%) in the per protocol analysis. At baseline, the mean age was 73.7 ± 10.9 years, 65.9% were male, 51.3% had HF with preserved ejection fraction and 58.7% were on New York Heart Association functional class II. CHA2 DS2 -VASc was 4.1 ± 1.5. During the follow-up, 11.6% of patients died and around one-quarter of patients were hospitalized or visited the emergency department, being HF worsening/progression the main cause (51.1%), with a 2.9% of thromboembolic events and 2.0% of acute coronary syndromes. Major bleeding occurred in 3.1% of patients, with 0.5% experiencing intracranial bleeding but no fatalities. Compliance with HF treatment was associated with a lower risk of death (hazard ratio: 0.092; 95% confidence interval: 0.03-0.31). CONCLUSIONS: Among patients with HF and AF anticoagulated with rivaroxaban, incidences of thromboembolic or hemorrhagic complications were low. The most important factor for improving survival was compliance with HF drugs, what strengths the need for early treatment with HF disease-modifying therapy and anticoagulation.

New nitrosyl ruthenium complexes with combined activities for multiple cardiovascular disorders.

Nitrosyl ruthenium complexes are promising platforms for nitric oxide (NO) and nitroxyl (HNO) release, which exert their therapeutic application. In this context, we developed two polypyridinic compounds with the general formula cis-[Ru(NO)(bpy)2(L)]n+, where L is an imidazole derivative. These species were characterized by spectroscopic and electrochemical techniques, including XANES/EXAFS experiments, and further supported by DFT calculations. Interestingly, assays using selective probes evidenced that both complexes can release HNO on reaction with thiols. This finding was biologically validated by HIF-1α detection. The latter protein is related to angiogenesis and inflammation processes under hypoxic conditions, which is selectively destabilized by nitroxyl. These metal complexes also presented vasodilating properties using isolated rat aorta rings and demonstrated antioxidant properties in free radical scavenging experiments. Based on these results, the new nitrosyl ruthenium compounds showed promising characteristics as potential therapeutic agents for the treatment of cardiovascular conditions such as atherosclerosis, deserving further investigation.

[Descriptive study about non-formal sex education resources available in Spain.] / Estudio descriptivo de los recursos sobre Educación Sexual en el ámbito no-formal disponibles en España.

OBJECTIVE: Sex education (SE) is a fundamental element of a fulfilling and safe life. Currently, education is understood beyond what happens inside the classroom. The aim of this research was to describe and to compare sex education resources available in official webs of Autonomous Communities of Spain (ACS) that to could be used in non-formal educational context. METHODS: A review of the ACS official web pages related to healthcare, education, youth, family and equality was made. Finally, 216 resources were selected for descriptive analysis. The resources were classified based on United Nations Educational, Scientific and Cultural Organization's (UNESCO) Technical Guidelines. RESULTS: 64% of resources were targeted at young people/adolescents. 80% dealt some specific issues, the most frequent being Reproductive Health, Violence and Gender. Values and Rights related to sexuality, Skills for Health and Well-being and Sexual behaviour are issues rarely addressed. Only 6 ACS were a social network profile related to SE. ACS with the widest diversity of issues addressed were Andalusia, Asturias and the Canary Islands. CONCLUSIONS: Homogeneity in the kind of resources and issues disparity reveals potential inequities in SE access in Spain. To enhance out-of-school environments learning can provide better successful health promotion. UNESCO's guidelines can be used to classify educational resource content and to identify the institutions that have best integrated actual SE paradigm.

OBJETIVO: La educación sexual (ES) es fundamental para una vida plena y segura. Actualmente, la educación es entendida más allá de lo que ocurre dentro de las aulas. El objetivo de este trabajo fue describir y comparar los materiales disponibles en las distintas webs oficiales de las comunidades y ciudades autónomas de España (CC. AA.) sobre ES y que puedan ser utilizados en contextos educativos no-formales. METODOS: Se realizó una revisión de las webs oficiales de las CC. AA. relacionadas con salud, educación, juventud, familia y/o igualdad. Se seleccionaron 216 recursos para su análisis descriptivo. Siguiendo las Orientaciones Técnicas de la Organización de las Naciones Unidas para la Educación, la Ciencia y la Cultura (UNESCO), se clasificaron los recursos en función de los temas que abordaban. RESULTADOS: El 64% de los recursos estaba dirigido a jóvenes/adolescentes. El 80% trataba algún tema en específico, siendo los más frecuentes Reproducción, Violencia y Género. Los temas: Valores y derechos relacionados con la sexualidad, Habilidades para la salud y bienestar y Conducta sexual fueron contenidos raramente tratados. Sólo 6 CC. AA. contaban con un perfil en redes sociales relacionado con ES. Las CC. AA. con mayor diversidad de temas abordados fueron Andalucía, Asturias y Canarias. CONCLUSIONES: La homogeneidad en el tipo de recursos y la disparidad de temáticas revela potenciales inequidades en el acceso a la ES en España. Potenciar medios de aprendizaje fuera de las escuelas puede lograr una promoción de la salud más efectiva. Las orientaciones de la UNESCO pueden servir para clasificar los contenidos e identificar las instituciones que mejor han integrado el actual paradigma que la ES propone.

Bacterial cellulose production by Komagataeibacter hansenii can be improved by successive batch culture.

Bacterial cellulose (BC) is a biopolymer principally synthetized by strains of the genus Komagataeibacter. However, high costs and low production yield make large-scale application difficult. The aim of this work was to evaluate the effects of successive batch culture before fermentation on the ability to increase the capacity of bacterial cellulose biosynthesis by a low-producing strain. The Komagataeibacter hansenii strain ATCC 23,769 was initially cultivated in fermentation broth for two periods of 35 or 56 days under static conditions. At the end of each period of time, they were transferred to new broth to be cultivated again (new batch culture cycle) for 35 or 56 days and carried out in parallel with a 10-day fermentation to determine the quantity of BC produced. As a result, a greater increase was observed after the end of the second and third batch cultures of 56 days (increases of 137% and 187% in relation to the nonbatch cultured strain, respectively). The produced samples presented higher crystallinity and thermal properties but lower water holding capacity. Through this work, it was concluded that the longer the batch culture time was, the greater the increase in the capacity of cellulose biosynthesis, which also depended on the number of successive batch culture cycles carried out.

Estudio descriptivo de los recursos sobre Educación Sexual en el ámbito no-formal disponibles en España / Descriptive study about non-formal sex education resources available in Spain

FUNDAMENTOS: La educación sexual (ES) es fundamental para una vida plena y segura. Actualmente, la educación es entendidamás allá de lo que ocurre dentro de las aulas. El objetivo de este trabajo fue describir y comparar los materiales disponibles en lasdistintas webs oficiales de las comunidades y ciudades autónomas de España (CC. AA.) sobre ES y que puedan ser utilizados encontextos educativos no-formales. MÉTODOS: Se realizó una revisión de las webs oficiales de las CC. AA. relacionadas con salud, educación, juventud, familia y/o igual-dad. Se seleccionaron 216 recursos para su análisis descriptivo. Siguiendo las Orientaciones Técnicas de la Organización de las Nacio-nes Unidas para la Educación, la Ciencia y la Cultura (UNESCO), se clasificaron los recursos en función de los temas que abordaban.RESULTADOS: El 64% de los recursos estaba dirigido a jóvenes/adolescentes. El 80% trataba algún tema en específico, siendo losmás frecuentesReproducción,Violencia yGénero. Los temas:Valores y derechos relacionados con la sexualidad,Habilidades para lasalud y bienestar yConducta sexual fueron contenidos raramente tratados. Sólo 6 CC. AA. contaban con un perfil en redes socialesrelacionado con ES. Las CC. AA. con mayor diversidad de temas abordados fueron Andalucía, Asturias y Canarias.CONCLUSIONES: La homogeneidad en el tipo de recursos y la disparidad de temáticas revela potenciales inequidades en el ac-ceso a la ES en España. Potenciar medios de aprendizaje fuera de las escuelas puede lograr una promoción de la salud más efectiva.Las orientaciones de la UNESCO pueden servir para clasificar los contenidos e identificar las instituciones que mejor han integradoel actual paradigma que la ES propone.(AU)

BACKGROUND: Sex education (SE) is a fundamental element of a fulfilling and safe life. Currently, education is understood beyondwhat happens inside the classroom. The aim of this research was to describe and to compare sex education resources available inofficial webs of Autonomous Communities of Spain (ACS) that to could be used in non-formal educational context.METHODS: A review of the ACS official web pages related to healthcare, education, youth, family and equality was made. Finally,216 resources were selected for descriptive analysis. The resources were classified based on United Nations Educational, Scientific andCultural Organization’s (UNESCO) Technical Guidelines.RESULTS // 64% of resources were targeted at young people/adolescents. 80% dealt some specific issues, the most frequentbeingReproductive Health,Violence andGender.Values and Rights related to sexuality,Skills for Health and Well-being andSexualbehaviour are issues rarely addressed. Only 6 ACS were a social network profile related to SE. ACS with the widest diversity of issuesaddressed were Andalusia, Asturias and the Canary Islands.CONCLUSIONS: Homogeneity in the kind of resources and issues disparity reveals potential inequities in SE access in Spain. Toenhance out-of-school environments learning can provide better successful health promotion. UNESCO’s guidelines can be used toclassify educational resource content and to identify the institutions that have best integrated actual SE paradigm.(AU)

Efectos psicológicos del distanciamiento social en estudiantes de medicina / Efeitos psicológicos do distanciamento social em estudantes de medicina / Psychological effects of social distancing on medical students

Objetivo:Estimar la prevalencia de síntomas de ansiedad y depresión en estudiantes. Metodología: Estudio transversal, descriptivo y observacional, con enfoque cuantitativo, realizado en un Centro Universitario con la aplicación de un formulario electrónico en línea con 170 estudiantes universitarios, utilizando el Cuestionario de Salud del Paciente-9, instrumento que evalúa el trastorno depresivo, y el Trastorno de Ansiedad General- 7, que evalúa y monitorea la ansiedad. Resultados: Se encontró que el 42,9% de los estudiantes tenían ansiedad moderada y el 37,0% de los participantes tenían trastorno depresivo moderado. Los estudiantes de medicina con edades entre 25 y 29 años, sin trastorno psicológico previo, fueron los más propensos a mostrar mayores signos de depresión y ansiedad durante la pandemia, y los estudiantes informaron que les hubiera gustado recibir apoyo psicológico de la universidad durante este período. Conclusión: Las instituciones educativas deben brindar apoyo multilateral, incluidas las intervenciones tempranas de salud mental, especialmente durante tiempos de pandemia. (AU)

Objetivo: Estimar a prevalência de sintomas de ansiedade e depressão em estudantes. Método: Estudo de natureza transversal, descritivo e observacional, com abordagem quantitativa, realizado em um Centro Universitário com a aplicação de um formulário eletrônico online com 170 universitários, utilizando o Patient Health Questionnaire-9, instrumento que avalia transtorno depressivo, e o General Anxiety Disorder-7, que avalia e monitora a ansiedade. Resultados: Verificou-se que 42,9% dos estudantes se encontravam com ansiedade na fase moderada e 37,0% dos participantes possuíam transtorno depressivo moderado. Asestudantes de medicina na faixa etária de 25 a 29 anos, sem transtorno psíquico prévio foram os mais susceptíveis a apresentarem maiores indícios de depressão e ansiedade durante a pandemia e os discentesrelataram que gostariam de ter recebido suporte psicológico da universidade durante esse período. Conclusões: As instituições de ensino necessitam fornecer apoio multilateral, incluindo intervenções precoces de saúde mental, principalmente em momentos pandêmicos. (AU)

Objective: To estimate the prevalence of anxiety and depression symptoms in students. Method: A cross-sectional, descriptive and observational study with a quantitative approach, carried out in a University Center by applying an online electronic form to 170 university students, using the Patient Health Questionnaire-9, an instrument that assesses depressive disorder, and the General Anxiety Disorder-7 scale, which assesses and monitors anxiety. Results: It was verified that 42.9% of the students had moderate anxiety and 37.0% of the participants had moderate depressive disorder. Medical students aged between 25 and 29 years old with no previous psychological disorder were the most susceptible to presenting greater signs of depression and anxiety during the pandemic, and the students reported that they would have liked to have received psychological support from the university during this period. Conclusions: Educational institutions need to provide multilateral support, including early mental health interventions, especially during pandemic times. (AU)

Feasibility and outcomes of transjugular intrahepatic portosystemic shunts in infants.

BACKGROUND: Experience with transjugular intrahepatic portosystemic shunts (TIPS) in the pediatric population, especially in infants, is limited. OBJECTIVE: To evaluate the feasibility, efficacy and safety of TIPS placement in infants. MATERIALS AND METHODS: This retrospective non-comparative observational cohort study analyzed all pediatric patients < 12 months of age treated with TIPS while waiting for liver transplant between October 2018 and April 2021. The sample consisted of 10 infants with chronic liver disease. All had refractory ascites and decreased portal vein size. Their mean age ± standard deviation was 5 ± 1 months and their mean weight was 5.4 ± 1.0 kg. We calculated the pediatric end-stage liver disease score and portosystemic gradients before and after TIPS placement. We used ultrasound to check for complications and to assess the presence of ascites. We used paired-sample t-test for the mean comparison of paired variables. RESULTS: Ten TIPS procedures were performed that were technically and hemodynamically successful except for one, in which an extrahepatic portal puncture required surgical repair. Ascites resolved in three infants and was reduced in six. The portal vein size remained stable after TIPS placement. Four infants had early stent thrombosis and two had late stent thrombosis treated with angioplasty or covered stents. CONCLUSION: TIPS placement in infants is a feasible, safe and effective procedure.