Assessing the individual risk of stroke in caregivers of patients with stroke.

BACKGROUND: Genetic factors influence the risk of developing stroke. Still, it is unclear whether this risk is intrinsically high in certain people or if nongenetic factors explain it entirely. OBJECTIVE: To compare the risk of stroke in kin and nonkin caregivers. METHODS: In a cross-sectional study using the Stroke Riskometer app (AUT Ventures Limited, Auckland, AUK, New Zealand), we determined the 5- and 10-year stroke risk (SR) among caregivers of stroke inpatients. The degree of kinship was rated with a score ranging from 0 to 50 points. RESULTS: We studied 278 caregivers (69.4% of them female) with a mean age of 47.5 ± 14.2 years. Kin caregivers represented 70.1% of the sample, and 49.6% of them were offspring. The median SR at 5 years was of 2.1 (range: 0.35-17.3) versus 1.73 (range: 0.04-29.9), and of 4.0 (range: 0.45-38.6) versus 2.94 (range: 0.05-59.35) at 10 years for the nonkin and kin caregivers respectively. In linear logistic regression controlled for the age of the caregivers, adding the kinship score did not increase the overall variability of the model for the risk at 5 years (R2 = 0.271; p = 0.858) nor the risk at 10 years (R2 = 0.376; p = 0.78). CONCLUSION: Caregivers of stroke patients carry a high SR regardless of their degree of kinship.

ANTECEDENTES: Los factores genéticos probablemente influyen en el riesgo de desarrollar enfermedad vascular cerebral (EVC), pero no está claro si el riesgo es intrínsecamente alto o si es totalmente explicado por factores modificables. OBJETIVO: Comparar el riesgo de EVC (REVC) en cuidadores pertenecientes y no pertenecientes a la misma familia de pacientes con EVC. MéTODOS: En un estudio transversal que utilizó la aplicación Stroke Riskometer (AUT Ventures Limited, Auckland, AUK, Nueva Zelanda), determinamos el REVC a 5 y 10 años en cuidadores de pacientes hospitalizados por EVC. El grado de parentesco se graduó con un puntaje de 0 a 50 dependiendo de su relación familiar con el paciente. RESULTADOS: Estudiamos a 278 cuidadores (69.4% de ellos mujeres) con edad media de 47.5 ± 14.2 años. Los cuidadores familiares representaron el 70.1% de la muestra, siendo el 49.6% hijos. Las medianas de REVC a 5 años fueron de 2.1 (rango: 0.35­17.3) versus 1.73 (rango: 0.04­29.9), y de 4.0 (rango: 0.45­38.6) versus 2.94 (rango: 0.05­59.35) a 10 años para el grupo de cuidadores familiares y no familiares, respectivamente. En una regresión logística lineal contralando para la edad de los cuidadores, la adición del puntaje de parentesco no incrementó la variabilidad general del modelo para el riesgo a 5 años (R2 = 0.271; p = 0.858) ni para el riesgo a 10 años (R2 = 0.376; p = 0.78). CONCLUSIóN: Los cuidadores de pacientes con EVC tienen un REVC alto, independientemente de su grado de parentesco.

Assessing the individual risk of stroke in caregivers of patients with stroke / Evaluación del riesgo individual de enfermedad cerebrovascular en cuidadores de pacientes con enfermedad cerebrovascular

Abstract Background Genetic factors influence the risk of developing stroke. Still, it is unclear whether this risk is intrinsically high in certain people or if nongenetic factors explain it entirely. Objective To compare the risk of stroke in kin and nonkin caregivers. Methods In a cross-sectional study using the Stroke Riskometer app (AUT Ventures Limited, Auckland, AUK, New Zealand), we determined the 5- and 10-year stroke risk (SR) among caregivers of stroke inpatients. The degree of kinship was rated with a score ranging from 0 to 50 points. Results We studied 278 caregivers (69.4% of them female) with a mean age of 47.5 ± 14.2 years. Kin caregivers represented 70.1% of the sample, and 49.6% of them were offspring. The median SR at 5 years was of 2.1 (range: 0.35-17.3) versus 1.73 (range: 0.04-29.9), and of 4.0 (range: 0.45-38.6) versus 2.94 (range: 0.05-59.35) at 10 years for the nonkin and kin caregivers respectively. In linear logistic regression controlled for the age of the caregivers, adding the kinship score did not increase the overall variability of the model for the risk at 5 years (R2= 0.271; p= 0.858) nor the risk at 10 years (R2= 0.376; p= 0.78). Conclusion Caregivers of stroke patients carry a high SR regardless of their degree of kinship.

Resumen Antecedentes Los factores genéticos probablemente influyen en el riesgo de desarrollar enfermedad vascular cerebral (EVC), pero no está claro si el riesgo es intrínsecamente alto o si es totalmente explicado por factores modificables. Objetivo Comparar el riesgo de EVC (REVC) en cuidadores pertenecientes y no pertenecientes a la misma familia de pacientes con EVC. Métodos En un estudio transversal que utilizó la aplicación Stroke Riskometer (AUT Ventures Limited, Auckland, AUK, Nueva Zelanda), determinamos el REVC a 5 y 10 años en cuidadores de pacientes hospitalizados por EVC. El grado de parentesco se graduó con un puntaje de 0 a 50 dependiendo de su relación familiar con el paciente. Resultados Estudiamos a 278 cuidadores (69.4% de ellos mujeres) con edad media de 47.5 ± 14.2 años. Los cuidadores familiares representaron el 70.1% de la muestra, siendo el 49.6% hijos. Las medianas de REVC a 5 años fueron de 2.1 (rango: 0.35-17.3) versus 1.73 (rango: 0.04-29.9), y de 4.0 (rango: 0.45-38.6) versus 2.94 (rango: 0.05-59.35) a 10 años para el grupo de cuidadores familiares y no familiares, respectivamente. En una regresión logística lineal contralando para la edad de los cuidadores, la adición del puntaje de parentesco no incrementó la variabilidad general del modelo para el riesgo a 5 años (R2= 0.271; p= 0.858) ni para el riesgo a 10 años (R2= 0.376; p= 0.78). Conclusión Los cuidadores de pacientes con EVC tienen un REVC alto, independientemente de su grado de parentesco.

Improved antitumor activity through a tyramidyl maslinic acid derivative. Design and validation as drug-loaded electrospun polymeric nanofibers.

Among the most harmful tumors detected in the human body, such as breast, colon, brain or pancreas, breast (BC) and colorectal cancer (CRC) are the first and third most frequent cancer worldwide, respectively. The current existing chemotherapeutic treatments present serious side effects due to their intravenous administration can induce cytotoxicity in healthy cells. Thus, new treatment methods based on drug-loaded polymeric nanofibers (NFs) have gained significant potential for their use in localized cancer chemotherapy. Here, a deep in vitro comparative analysis between maslinic acid (MA) and a tyramine-maslinic acid (TMA) derivative is initially performed. This analysis includes a proliferation, and a cell cycle assay, and a genotoxicity, antiangiogenic and apoptosis study. Then, the TMA derivative has been incorporated into electrospun polymeric NFs obtaining an implantable dressing material with antitumor activity. Two types of patches containing TMA-loaded polymeric NFs of poly(caprolactone) (PCL), and a mixture of polylactic acid/poly(4-vinylpyridine) (PLA/PVP) were fabricated by the electrospinning technique. The characterization of the drug-loaded NFs showed an encapsulation capacity of 0.027 mg TMA/mg PCL and 0.024 mg TMA/mg PLA/PVP. Then, the cytotoxic activity of both polymeric systems was tested in CRC (T84), BC (MCF-7) and a no tumor (L929) cell lines exposed to TMA-loaded NFs and blank NFs for 48 h. Moreover, cell cycle assay, genotoxicity, angiogenesis and apoptosis tests were carried out to study the mechanism of action of TMA. Blank NFs showed no-toxicity in all cell lines tested and both drug-loaded NFs significantly reduced cell proliferation (relative proliferation of ≈44 % and ≈25 % respectively). Therefore, TMA was less genotoxic than maslinic acid (MA), and reduced VEGFA expression in MCF-7 cells (1.32 and 2.12-fold for MA and TMA respectively). These results showed that TMA-loaded NFs could constitute a promising biocompatible and biodegradable nanoplatform for the local treatment of solid tumors such as CRC or BC.

Isolation of Mycosporine-like Amino Acids from Red Macroalgae and a Marine Lichen by High-Performance Countercurrent Chromatography: A Strategy to Obtain Biological UV-Filters.

Marine organisms have gained considerable biotechnological interest in recent years due to their wide variety of bioactive compounds with potential applications. Mycosporine-like amino acids (MAAs) are UV-absorbing secondary metabolites with antioxidant and photoprotective capacity, mainly found in organisms living under stress conditions (e.g., cyanobacteria, red algae, or lichens). In this work, five MAAs were isolated from two red macroalgae (Pyropia columbina and Gelidium corneum) and one marine lichen (Lichina pygmaea) by high-performance countercurrent chromatography (HPCCC). The selected biphasic solvent system consisted of ethanol, acetonitrile, saturated ammonium sulphate solution, and water (1:1:0.5:1; v:v:v:v). The HPCCC process for P. columbina and G. corneum consisted of eight separation cycles (1 g and 200 mg of extract per cycle, respectively), whereas three cycles were performed for of L. pygmaea (1.2 g extract per cycle). The separation process resulted in fractions enriched with palythine (2.3 mg), asterina-330 (3.3 mg), shinorine (14.8 mg), porphyra-334 (203.5 mg) and mycosporine-serinol (46.6 mg), which were subsequently desalted by using precipitation with methanol and permeation on a Sephadex G-10 column. Target molecules were identified by HPLC, MS, and NMR.

Integrated microfluidic systems for fluorescence monitoring rapid kinetic reactions in bioanalysis.

A stopped-flow microfluidic fluorimetric biosensor to monitor alkaline phosphatase (ALP) activity and evaluate the potential inhibitors has been developed, integrating a magnetically retained enzyme microreactor (MREµR) in the reaction/detection zone of the microfluidic chip. The integration supposed the alignment of the MREµR at the sample compartment of a conventional spectrofluorometer using a 3D-printed device. The analytical signal is based on the fluorescence decrease in the signal obtained in the dephosphorylation reaction of the substrate 4-methylumbelliferone phosphate (4-MUP) by the retained ALP-MNPs in an alkaline medium caused by sulfonamides. The excitation and emission wavelengths to monitor the reaction were 363 and 444 nm, respectively. Three sulfonamides, acetazolamide, furosemide, and sulfasalazine, have been used as model analytes. The front-face operating mode of the spectrofluorometer was used to acquire the instrumental signals. The influence of the rotation angle of the microfluidic device on the efficiency of the signal collection has also been studied, obtaining the signals with greater intensity at 75° from the excitation beam. The dynamic range of the calibration graph was 16.81-1111.22 µg mL-1, expressed as sulfonamide concentration, with a limit of detection of 5.04 µg mL-1 (R2 = 0.9989, n = 10, r = 3) for acetazolamide. The method was applied to determine sulfonamide residues in tap water and milk samples, with 88.9-98.7% recovery values. The results have been compared with those obtained using a commercial device connected to the spectrofluorometer, getting faster reaction kinetics.

Delivering acute stroke care in a middle-income country. The Mexican model: "ResISSSTE Cerebro".

Introduction: Founded in 2019, the "ResISSSTE Cerebro" program is the first and only stroke network within the Mexican public health system. One advanced stroke center (ASC) and seven essential stroke centers (ESC) provide acute stroke (AS) care through a modified hub-and-spoke model. This study describes the workflow, metrics, and outcomes in AS obtained during the program's third year of operation. Materials and methods: Participants were adult beneficiaries of the ISSSTE health system in Mexico City with acute focal neurological deficit within 24 h of symptom onset. Initial evaluation could occur at any facility, but the stroke team at the ASC took all decisions regarding treatment and transfers of patients. Registered variables included demographics, stroke risk factors, AS treatment workflow time points, and clinical outcome measures. Results: We analyzed data from 236 patients, 104 (44.3%) men with a median age of 71 years. Sixty percent of the patients were initially evaluated at the ESC, and 122 (85.9%) were transferred to the ASC. The median transfer time was 123 min. The most common risk factor was hypertension (73.6%). Stroke subtypes were ischemic (86.0%) and hemorrhagic (14.0%). Median times for onset-to-door, door-to-imaging, door-to-needle, and door-to-groin were: 135.5, 37.0, 76.0, and 151.5 min, respectively. The rate of intravenous thrombolysis was 35%. Large vessel occlusion was present in 63 patients, from whom 44% received endovascular therapy; 71.4% achieved early clinical improvement (median NIHSS reduction of 11 points). Treatment-associated morbimortality was 3.4%. Conclusion: With the implementation of a modified hub-and-spoke model, this study shows that delivery of AS care in low- and middle-income countries is feasible and achieves good clinical outcomes.

Growth performance, carcass, and meat quality traits of Tropical Milking criollo bulls fed with two energy-level diets.

The aim of this study was to determine the effect of two energy-level diets on the beef performance of Tropical Milking criollo bulls grouped by weight and age in three periods: initial, middle, and final. Evidence on intensive beef production from Tropical Milking criollo cattle breeds are unknown, and productive alternatives for dairy producers in the hot tropics are needed. Bulls were fed in each period with low (LE, 2.2 Mcal ME/kg DM) and high (HE, 2.9 Mcal ME/kg DM) energy diets and content phase feeding protein of 14.5, 12.0, and 10.3%, respectively. For each period, ten bulls were randomly assigned to diets. In all periods, growth performance for final body weight, average daily gain, feed intake, and feed conversion were all superior in HE (p ≤ 0.05). For the final period, slaughter body, hot and cold carcass weights, and dressing were also superior in HE (p ≤ 0.05); for meat quality traits, differences were observed in muscles Longissimus dorsi, Semimembranosus, Infraspinatus, and Serratus ventralis for pH and tenderness (p ≤ 0.05), although not for diets. For color L*, a*, and b* system, neither diet nor muscle had effect on L* (p > 0.05); however, the diet-muscle interaction was significant for a* (p ≤ 0.05), and only muscle effect was detected for b* (p ≤ 0.05). Tropical Milking bulls responded positively to a high-energy diet, despite not being a beef breed.

Study of the inhibition effects on glutathione peroxidase immobilized on MNPs using a stopped-flow microfluidic system.

A stopped-flow microfluidic system to monitor glutathione peroxidase (GPx) activity and evaluate potential inhibitors of the enzyme has been developed based on the integration of the microfluidic chip in the reaction/detection zone. This integration supposes the physical alignment at the optimal location of the microfluidic channel, both the magnetically retained enzyme microreactor (MREµR) and the remote luminescence detection using a focused bifurcated fiber optic bundle (BFOB) connected to a conventional spectrofluorometer detector. The method is based on the coupling of two competitive oxidative chemical reactions, in which glutathione (GSH) and homovanillic acid (HVA) competed for their interaction with hydrogen peroxide in the presence of the magnetically retained GPx-MNPs. The biocatalytic reaction was followed by monitoring the fluorescence of the biphenyl-HVA dimer formed. The dynamic range of the calibration graph was 0.45-10 µmol L-1, expressed as GSH concentration with a detection limit of 0.1 µmol L-1 (r2 = 0.9954, n = 10, r = 3). The precision expressed as the relative standard deviation (RSD%) was between 0.5 and 3.9%. The stopped-flow microfluidic system showed a sampling frequency of 25 h-1. The method was applied to the study of GPx inhibition provided by three inhibitory compounds, two metallic ions Hg(II) and Cu(II) and t-butyl hydroperoxide, and their presence in liquid samples, as water, milk, and edible oil. Recovery values between 88.7 and 99.4% were achieved in all instances.

Effect of size and location of unruptured intracranial aneurysms on self-reported headache.

AIM: To describe the relationship between aneurysm size and location and the prevalence of headache at diagnosis and three-and-six-month follow-up in a sample of patients with UIAs. MATERIAL AND METHODS: In this cohort study, patients were diagnosed with UIAs by digital subtraction angiography. Follow-up visits occurred three and six months after the diagnosis. Headache presence was registered and further classified by phenotypes. After DSA, recorded variables were: aneurysm number, morphology, location, and size (diameter [W], neck [N], and dome-neck distance [H]). The aspect ratio (H/N) and the dome/neck ratio (W/N) were calculated. The outcome of this study was the self-reported headache status at follow-up. RESULTS: Data from 42 patients and 46 aneurysms were available, 81.0% women, with a mean age of 57.4±14.3 years. Headache was reported by 61.9% of the patients. The pain phenotype was tension-type in 38.1%, migraine in 11.9%, neuralgia in 2.4%, and unclassifiable in 9.5%. The median (min-max) measurements were W=5.05 (0.89-22.9); N=3.02 (0.52-17.9); H=5.08 (0.92-23.0); aspect ratio 1.59 (0.68-17.69) and W/N ratio 1.65 (0.62-16.92). Thirty-three patients (37 aneurysms) received treatment, 47.8% by surgical clipping and 32.6% by endovascular occlusion. In treated patients, the headache persisted in 14.3% on the first and 9.5% on the second visit. There were no differences in any registered variables between patients with and without headaches at follow-up. CONCLUSION: This study found data that supports that headache in patients with UIAs improves after treatment and that such improvement is probably unrelated to the size and shape of the UIAs.

Efficiency of Diagnostic Test for SARS-CoV-2 in a Nursing Home.

BACKGROUND: there is no consensus on how to optimally use diagnostic tests in each stage of COVID-19 pandemic. The objective of this research is to determine the efficiency of sorting positive antibody test quarterly. METHODS: this research uses a retrospective, observational study. COVID-19 diagnostic tests performed and avoided refer to a Spanish nursing home. POPULATION: 261 employees and 107 residents. A quarterly antibody test was performed on subjects who had tested positive during the first wave of coronavirus, and a antibody rapid test on the remaining subjects. RESULTS: during the first wave, 24.0% of the employees and 51.4% of the residents had a positive antibody test. Seronegativization was observed in 7.6% of employees and 1.6% of residents. An employee was infected with COVID-19 in September 2020, followed by a nursing home outbreak in October: 118 Polymerase Chain Reactions tests were avoided in residents and 18 in employees, which in turn prevented 15 workers from going on sick leave and the quarantine of 59 residents. This represents savings of about $15,000. CONCLUSIONS: our study supports the need to know and apply the strategies for early detection, surveillance and control of COVID-19 for future outbreaks. We conclude that surveillance for positive COVID-19 serology among long-term care staff and residents may be a cost-effective strategy during a pandemic.

Fatal arrhythmia following ingestion of hawthorn root (Crataegus pubescens) extract: a case report.

The use of extracts from the hawthorn plant as cardiovascular agents dates back to the 1st century; recently, they have also been made available online as weight loss aids. Herein, we present a case of intentional intoxication with hawthorn root extract (HRE) in an adult patient that resulted in death. A 20-year-old female patient, who was clinically diagnosed with depression, developed hypotension, bradycardia, and depressed consciousness after ingestion of this extract. An electrocardiogram recorded a sinus arrest with a slow nodal rhythm, which rapidly deteriorated, leading to cardiac arrest. This case report illustrates the potentially fatal consequences of HRE for which the constituents have not yet been characterized. All physicians, especially those in the emergency department, should be aware of the dangerous, even potentially fatal interactions of HRE with prescription medications.

The Development of the Bengamides as New Antibiotics against Drug-Resistant Bacteria.

The bengamides comprise an interesting family of natural products isolated from sponges belonging to the prolific Jaspidae family. Their outstanding antitumor properties, coupled with their unique mechanism of action and unprecedented molecular structures, have prompted an intense research activity directed towards their total syntheses, analogue design, and biological evaluations for their development as new anticancer agents. Together with these biological studies in cancer research, in recent years, the bengamides have been identified as potential antibiotics by their impressive biological activities against various drug-resistant bacteria such as Mycobacterium tuberculosis and Staphylococcus aureus. This review reports on the new advances in the chemistry and biology of the bengamides during the last years, paying special attention to their development as promising new antibiotics. Thus, the evolution of the bengamides from their initial exploration as antitumor agents up to their current status as antibiotics is described in detail, highlighting the manifold value of these marine natural products as valid hits in medicinal chemistry.

Nanoscale Biocompatible Structures Generated from Fluorinated Tripodal Phenylenes on Gold Nanoprisms.

Modification of gold substrates with a stable, uniform and ultrathin layer of biocompatible materials is of tremendous interest for the development of bio-devices. We present the fabrication of hybrid systems consisting of triangular prism gold nanoparticles (Au@NTPs) covalently covered with tripod-shaped oligo(p-phenylenes) featuring trifluoromethyl groups. Their synthesis is accomplished using a biphenyl boronic ester as the key compound. Au@NTPs were prepared through a seedless procedure using 3-butenoic acid and benzyldimethyl ammonium chloride, and modified with aminothiol groups. Coverage of this amine-modified gold substrate with a self-assembled monolayer (SAM) of tripod-shaped molecules is carried out in ethanolic solution. The hybrid system avoids up to 70 % of protein corona formation, and allows unspecific attachment for bulky adsorbates, providing an optimal biosensing platform. Chemical composition and morphology are analyzed by transmission electron microscopy (TEM), UV-visible spectroscopy and field emission scanning electron microscopy (FESEM).

Content and Quality of Information about Stroke in Wikipedia across Multiple Languages.

BACKGROUND: Given the high contribution of stroke to the global burden of disease, there is a need for good-quality information on Web platforms such as Wikipedia. AIMS: This study aimed to describe the quality of the Wikipedia articles on stroke written in different languages. METHODS: We studied the world's 30 most spoken languages. With the DISCERN score, we evaluated the quality of the information within the Wikipedia articles. Three investigators assessed each of the texts translated to English. We also registered the word count, the number of references, and if the text referred to the emergency status of stroke, cues to suspect a stroke, and allusions to endovascular treatment. RESULTS: There is a Wikipedia article for stroke in 23 out of the 30 languages. The mean DISCERN score was 35 29.9 ± 9.2. Overall quality ranged from 3/5 in 26.1% to 1/5 in 17.4%. Word count had a mean of 36 3,145.8 ± 3,048.9 words, and the texts included a mean of 43.1 ± 57.3 references; 69.6% of the articles referred to stroke as a medical emergency, 52.2% included awareness symptoms, and 34.8% included endovascular management among the stroke treatments. Three pages included steroids as part of the stroke treatment. The DISCERN score was not correlated with the number of speakers, but it was positively correlated with the number of references (r = 0.90, p < 0.001) and the number of words (r = 0.78, p < 0.001) in the articles. CONCLUSION: The analyzed Wikipedia articles do not contain relevant and up-to-date information to the general population. Further, the content varies widely across the different languages and is missing for some of them. The missing versions disproportionally affect millions of potential information seekers in undeveloped countries.

Matrix metalloproteinase-2 and matrix metalloproteinase-9 serum levels in patients with vertebrobasilar dolichoectasia with and without stroke: case-control study.

PURPOSE: To describe the differences in the serum levels of MMP-2 and MMP-9 of patients with vertebrobasilar dolichoectasia (VBD) with and without acute stroke. METHODS: Case-control study. From an outpatient clinic, we recruited 14 controls and 19 patients with VBD. We also recruited 33 patients with stroke from two emergency departments, 14 without VBD (S/-VBD) and 19 with VBD (S/ + VBD). All the patients underwent serum MMP-2 and MMP-9 measurements and a non-contrast CT scan. Two investigators assessed the intracranial vertebral arteries (VA) and the basilar artery (BA) at the mid-pons. Diagnosis of VBD was made if the BA diameter was ≥ 4.5 mm. RESULTS: The mean age of the 66 patients studied was 57.6 + 16.0 years, 41% female. In the 33 patients with stroke, the median NIHSS was 8 (range 15); there were no differences in the NIHSS scores between both groups with stroke. Median MMP-2 levels were lower in the S/-VBD when compared to controls. Median MMP-9 serum levels were higher in both groups with VBD when compared to controls and the S/-VDB group. Both groups with stroke exhibited higher MMP-9 serum levels than controls but were not statistically different from those found in patients with VBD. Serum levels of MMP-9 were significantly correlated with the diameters of the BA (r = 0.344, p = 0.01) and the left VA (r = 0.305, p = 0.05). CONCLUSION: This study found that high serum levels of MMP-9 are associated with VBD independently of stroke and correlated with the degree of VBD.

Immunohistochemical analysis of epithelium adjacent to lip cancer: A meta-analysis.

OBJECTIVES: To identify the immunohistochemical pattern of non-tumoral epithelium adjacent to lip cancer (ANTE) to unveil molecular alterations and potential biomarkers in lip cancer patients. MATERIALS AND METHODS: A systematic search at MEDLINE, EMBASE and proceedings Web of Science, OpenGrey and WorldCat. The PICOS outline (Population: lip cancer patients; Intervention: immunostaining with biomarkers in surgical specimens; Comparisons: ANTE versus LC; Outcomes: primary-to identify the immunohistochemical pattern of peritumoral epithelium and secondary-to assess the immunoreactivity of LC epithelium; and Study design: cross-sectional, case-control and cohort studies). RESULTS: A total of 339 records were identified. Seven studies reporting on ANTE and LCs were included in the qualitative synthesis, and 4 of them (p53 immunostaining) were selected for meta-analysis. In the ANTE group, the pooled prevalence of p53 was 0.74 (95% CI: 0.66 - 0.82), while in the lip squamous cell carcinoma group this prevalence was 0.83 (95% CI: 0.75 - 0.89). CONCLUSIONS: Similar immunoexpression was found in lip epithelium adjacent to lip carcinoma, even in epithelia with normal appearance or mild histological alterations. The role of biomarkers in the follow-up of actinic cheilitis patients deserves additional clinical assessment.

Online audio-visual information on oral cancer for Spanish-speaking laypersons. A cross-sectional study / Información audiovisual online sobre el cáncer bucal para legos de habla hispana. Un estudio transversal

Background: Lack of knowledge and awareness of oral cancer seem to be the main causes of diagnostic delay.Online resources are often used by patients to obtain health/medical information. However, there are no reports onthe quality and usefulness of oral cancer audio-visual resources in Spanish. The aims of this investigation were todisclose the type of information about oral cancer available, and whether it may be useful to shorten the patients’oral cancer appraisal time-interval.Material and Methods: Cross-sectional study undertaken at three video-sharing sites on October, 13th 2019. Key-words: “Cáncer oral”; “cáncer de boca”. The first 100 results in each viewing list were retrieved by three review -ers. Demographical data was recorded, and interaction indexes, viewing rates, comprehensiveness, and usefulnesswere calculated for each video. The presence of non-scientifically supported information was also assessed. Adescriptive analysis was undertaken, and relationships between variables were explored using the Spearman cor-relation test.Results: A total of 127 videos were selected. They were produced mainly by mass-media (46.5%; n=59) andtheir length ranged from 0.28 to 105.38 minutes (median 4.15 minutes; IQR: 2.34-9.67). The most viewed video(10,599,765 views; visualization rate 726,508.9) scored 0 both in usefulness and comprehensiveness. The mostuseful video gathered 44,119 views (visualization rate 2.033.13). A highly significant positive correlation (0.643;p<0.001) could be observed between usefulness and comprehensiveness of the videos, together with negative cor-relations between the visualization rate and usefulness (-0.186; p<0.05), and visualization rate and comprehensive-ness (-0.183; p<0.05). Conclusions: Online audio-visual material about oral cancer in Spanish is incomplete, of limited usefulness, andoften includes non-scientifically supported information. Most of these resources are produced by mass media and...(AU)

COVID-19 Lockdown Effects on Acute Stroke Care in Latin America.

OBJECTIVES: COVID-19 pandemic has forced important changes in health care worldwide. Stroke care networks have been affected, especially during peak periods. We assessed the impact of the pandemic and lockdowns in stroke admissions and care in Latin America. MATERIALS AND METHODS: A multinational study (7 countries, 18 centers) of patients admitted during the pandemic outbreak (March-June 2020). Comparisons were made with the same period in 2019. Numbers of cases, stroke etiology and severity, acute care and hospitalization outcomes were assessed. RESULTS: Most countries reported mild decreases in stroke admissions compared to the same period of 2019 (1187 vs. 1166, p = 0.03). Among stroke subtypes, there was a reduction in ischemic strokes (IS) admissions (78.3% vs. 73.9%, p = 0.01) compared with 2019, especially in IS with NIHSS 0-5 (50.1% vs. 44.9%, p = 0.03). A substantial increase in the proportion of stroke admissions beyond 48 h from symptoms onset was observed (13.8% vs. 20.5%, p < 0.001). Nevertheless, no differences in total reperfusion treatment rates were observed, with similar door-to-needle, door-to-CT, and door-to-groin times in both periods. Other stroke outcomes, as all-type mortality during hospitalization (4.9% vs. 9.7%, p < 0.001), length of stay (IQR 1-5 days vs. 0-9 days, p < 0.001), and likelihood to be discharged home (91.6% vs. 83.0%, p < 0.001), were compromised during COVID-19 lockdown period. CONCLUSIONS: In this Latin America survey, there was a mild decrease in admissions of IS during the COVID-19 lockdown period, with a significant delay in time to consultations and worse hospitalization outcomes.

Development of an aptamer-based SPR-biosensor for the determination of kanamycin residues in foods.

A biosensor in which an affinity reaction occurs in the sensitive microzone through the use of specific aptamers to determine kanamycin residues in agri-food samples has been developed. It is an irreversible and continuous flow aptameric biosensor (aptasensor) in which the signal variations are monitored by surface plasmon resonance (SPR) measurements based on the specific interaction of the aptamer with the antibiotic. The signal variation is proportional to the analyte concentration. Graphene is known for efficient binding of molecules with its π-electron system, so a monolayer of graphene prepared from chemical vapor deposition (CVD) has been compared to a multilayer of graphene made from reduced graphene oxide (rGO) for immobilization of the aptamer on the gold surface of the physicochemical transducer. The best results have been obtained with CVD graphene. The dynamic range was between 1 and 100 µmol L-1 of kanamycin concentration (r2 = 0.9981, n = 7, r = 4), with a limit of detection of 285 nmol L-1 and a sampling frequency of 6 h-1. The precision, expressed as relative standard deviation (RSD%), was established in the range of 1.49 and 3.89%, calculated for 1, 10, and 50 µmol L-1. The selectivity was studied applying the described method to determine other antibiotics, obtaining no significant difference in the analytical signal. The method was applied to determine kanamycin residues in milk samples with recovery values ranging between 90 and 96%.