Enhancing biliary structure identification using percutaneous cholecystostomy drain delivery of indocyanine green: a glowing two case review.

The use of indocyanine green for fluorescent cholangiography in patients with cholecystitis initially treated with percutaneous cholecystostomy drainage catheters was described in this two case series. Two patients underwent robotic assisted cholecystectomy with fluorescent cholangiography and indocyanine green through percutaneous cholecystostomy drainage catheters. The patients were diagnosed with acute cholecystitis. Directed injection of indocyanine green allowed for direct visualization of the biliary system allowing for a safe identification of the critical view of safety. Injection of indocyanine green for fluorescent cholangiography through percutaneous cholecystostomy drainage catheters is reliable to assess the critical view of safety and allows for improved identification of the biliary tree anatomy. Administration of indocyanine green through the percutaneous cholecystostomy drainage catheters avoided background hepatic fluorescence and increased contrast between biliary structures.

Genetic risk score for insulin resistance based on gene variants associated to amino acid metabolism in young adults.

Circulating concentration of arginine, alanine, aspartate, isoleucine, leucine, phenylalanine, proline, tyrosine, taurine and valine are increased in subjects with insulin resistance, which could in part be attributed to the presence of single nucleotide polymorphisms (SNPs) within genes associated with amino acid metabolism. Thus, the aim of this work was to develop a Genetic Risk Score (GRS) for insulin resistance in young adults based on SNPs present in genes related to amino acid metabolism. We performed a cross-sectional study that included 452 subjects over 18 years of age. Anthropometric, clinical, and biochemical parameters were assessed including measurement of serum amino acids by high performance liquid chromatography. Eighteen SNPs were genotyped by allelic discrimination. Of these, ten were found to be in Hardy-Weinberg equilibrium, and only four were used to construct the GRS through multiple linear regression modeling. The GRS was calculated using the number of risk alleles of the SNPs in HGD, PRODH, DLD and SLC7A9 genes. Subjects with high GRS (≥ 0.836) had higher levels of glucose, insulin, homeostatic model assessment- insulin resistance (HOMA-IR), total cholesterol and triglycerides, and lower levels of arginine than subjects with low GRS (p < 0.05). The application of a GRS based on variants within genes associated to amino acid metabolism may be useful for the early identification of subjects at increased risk of insulin resistance.

Historical and Molecular Perspectives on the Presence of Helicobacter pylori in Latin America: A Niche to Improve Gastric Cancer Risk Assessment.

Helicobacter pylori (H. pylori) is responsible for causing chronic gastritis, which can cause peptic ulcer and premalignant lesions such as atrophic gastritis, intestinal metaplasia, and dysplasia, with the risk of developing gastric cancer. Recent data describe that H. pylori colonizes the gastric mucosa of more than 50% of the world's population; however, this bacterium has been described as infecting the human population since its prehistory. This review focuses on the populations and subpopulations of H. pylori, differentiated by the polymorphisms present in their constitutive and virulence genes. These genes have spread and associated with different human populations, showing variability depending on their geographical distribution, and have evolved together with the human being. The predominant genotypes worldwide, Latin America and Chile, are described to understand the genetic diversity and pathogenicity of H. pylori in different populations and geographic regions. The high similarity in the sequence of virulence genes between H. pylori strains present in Peruvian and Spanish natives in Latin America suggests a European influence. The presence of cagA-positive strains and vacA s1 m1 allelic variants is observed with greater prevalence in Chilean patients with more severe gastrointestinal diseases and is associated with its geographical distribution. These findings highlight the importance of understanding the genetic diversity of H. pylori in different regions of the world for a more accurate assessment of the risk of associated diseases and their potential impact on health.

NMR-Based Mitochondria Metabolomic Profiling: A New Approach To Reveal Cancer-Associated Alterations.

Studying metabolism may assist in understanding the relationship between normal and dysfunctional mitochondrial activity and various diseases, such as neurodegenerative, cardiovascular, autoimmune, psychiatric, and cancer. Nuclear magnetic resonance-based metabolomics represents a powerful method to characterize the chemical content of complex samples and has been successfully applied to studying a range of conditions. However, an optimized methodology is lacking for analyzing isolated organelles, such as mitochondria. In this study, we report the development of a protocol to metabolically profile mitochondria from healthy, tumoral, and metastatic tissues. Encouragingly, this approach provided quantitative information about up to 45 metabolites in one comprehensive and robust analysis. Our results revealed significant differences between whole-cell and mitochondrial metabolites, which supports a more refined approach to metabolic analysis. We applied our optimized methodology to investigate aggressive and metastatic breast cancer in mouse tissues, discovering that lung mitochondria exhibit an altered metabolic fingerprint. Specific amino acids, organic acids, and lipids showed significant increases in levels when compared with mitochondria from healthy tissues. Our optimized methodology could promote a better understanding of the molecular mechanisms underlying breast cancer aggressiveness and mitochondrial-related diseases and support the optimization of new advanced therapies.

Satisfacción con los cuidados de Enfermería proporcionados en una unidad de hospitalización de agudos de salud mental / Satisfaction with Nursing care provided at a hospitalization unit for acute Mental Health patients

Objetivo: analizar la satisfacción del paciente sobre los cuidados recibidos por el personal de Enfermería durante su ingreso en una unidad de hospitalización de agudos de salud mental.Métodos: estudio trasversal analítico realizado en 2021 en la unidad de hospitalización de agudos de Psiquiatría de un hospital del Vallés Occidental en Cataluña (España). La población de estudio fueron las personas con un ingreso superior a una semana que cumplimentaron la escala de Evaluación del Cuidado CAT-V (rango 27-135), en su versión validada al español. Además, se recogieron las variables clínicas de los participantes: a) tipo de ingreso: voluntario/involuntario, b) diagnóstico del ingreso, c) utilización de contención mecánica, d) consumo de tóxicos. Se realizó análisis univariado y comparativo de las variables recogidas.Resultados: se incluyeron 100 pacientes, con una media de edad de 42,5 años (19-72). El 55% (p= 55) fue mujer. La satisfacción obtuvo una puntuación mediana (P25-P75) de 114 (103-125), situándose en el cuarto cuartil de satisfacción. Los valores de satisfacción se mantuvieron en el cuarto cuartil, sin mostrar diferencias estadísticamente significativas en ninguno de los factores considerados, excepto en los valores relacionados con el uso de contención mecánica, que mostró diferencias estadísticas (p= 0,023), con peor percepción de satisfacción del cuidado para aquellos en los que se usaron, mediana (P25-P75) 96,5 (87-114), frente a los que no, 116 (108-125). Aunque no se observaron diferencias significativas para el resto de variables estudiadas se destaca que aumenta la satisfacción en los ingresos voluntarios y en las personas de mayor edad.Conclusiones: los pacientes presentaron alta satisfacción del cuidado recibido por el personal de Enfermería durante su ingreso en una unidad de hospitalización de agudos de salud mental. La prevalencia del uso de contenciones mecánicas tiene un impacto negativo sobre la satisfacción del cuidado recibido. (AU)

Objective: to analyse patient satisfaction regarding care received from the Nursing staff during their admission at a hospitalization unit for acute mental health patients.Methods: an analytical cross-sectional study conducted in 2021 at the hospitalization unit for acute Psychiatry patients at a Vallés Occidental hospital in Catalonia (Spain). The study population were those persons hospitalized for over a week who completed the Caring Assessment Tool CAT-V (range 27-135), in its version translated into Spanish. Besides, the clinical variables of participants were collected: a) type of admission: voluntary / involuntary, b) diagnosis at admission, c) use of mechanical restraint, d) use of toxic substances. There was univariate and comparative analysis of the variables collected.Results: the study included 100 patients, with 42.5 years as mean age (19-72); of these, 55% (p= 55) was female. Satisfaction obtained a median score (P25-P75) of 114 (103-125), and was placed in the fourth quartile. Satisfaction values stayed in the fourth quartile, without showing any statistically significant differences in any of the factors considered, except for those values associated with the use of mechanical restraint, which showed statistical differences (p= 0,023), with a worse perception of satisfaction with care in those for whom it was used, median (P25-P75) 96.5 (87-114), vs. those for whom it was not, 116 (108-125). Even though no significant differences were observed for the rest of variables studied, an increase in satisfaction stood out among voluntary admissions and older persons.Conclusions: patients presented high satisfaction with care received from Nursing staff during their admission at a hospitalization unit for acute mental health patients. The prevalence of the use of mechanical restraints had a negative impact on satisfaction with care received. (AU)

A 40-Year-Old Man with Anemia, Proctitis, Rectal Bleeding, and a Perianal Rash Due to Mpox (Monkeypox) Infection.

BACKGROUND A recently described zoonotic viral infection, mpox (monkeypox), is an Orthopoxvirus transmitted by close contact, which causes symptoms similar to smallpox, although less severe. This report presents the case of a 40-year-old man with anemia, proctitis, rectal bleeding, and a perianal rash due to mpox infection. CASE REPORT A 40-year-old man with a medical history of human immunodeficiency virus (HIV) and syphilis presented multiple times with progressive and painful perianal lesions. On initial presentation, swabbing of the lesions and polymerase chain reaction (PCR) testing confirmed a diagnosis of mpox infection, and treatment with a 14-day course of Tecovirimat was started. Nine days after initiating Tecovirimat, the patient presented again with worsening perianal pain and associated hematochezia resulting in acute symptomatic anemia. Despite a blood transfusion to treat his anemia, the patient's status declined as his viral symptoms progressed. Computed tomography (CT) investigation demonstrated significant proctitis with interval development of small perianal abscesses. A multidisciplinary approach for medical management and treatment was instituted. The resolution of the patient's anemia and mpox proctitis was confirmed on follow-up. CONCLUSIONS Despite treatment with antiviral agents, mpox infection can progress quickly; thus, swift management with a multidisciplinary approach and close follow-up is needed to treat and prevent secondary complications such as anemia and proctitis. Further data collection regarding the sexual practices of those with diagnoses of mpox as well as seminal, anorectal, and genital swabbing would be valuable to confirm the mode of transmission and cause of mpox proctitis.

Evaluation of Antimicrobial Activities of Nanoparticles and Nanostructured Surfaces In Vitro.

The antimicrobial activities of nanoparticles and nanostructured surfaces, such as silver, zinc oxide, titanium dioxide, and magnesium oxide, have been explored previously in clinical and environmental settings and in consumable food products. However, a lack of consistency in the experimental methods and materials used has culminated in conflicting results, even amongst studies of the same nanostructure types and bacterial species. For researchers who wish to employ nanostructures as an additive or coating in a product design, these conflicting data limit their utilization in clinical settings. To confront this dilemma, in this article, we present four different methods to determine the antimicrobial activities of nanoparticles and nanostructured surfaces, and discuss their applicability in different scenarios. Adapting consistent methods is expected to lead to reproducible data that can be compared across studies and implemented for different nanostructure types and microbial species. We introduce two methods to determine the antimicrobial activities of nanoparticles and two methods for the antimicrobial activities of nanostructured surfaces. For nanoparticles, the direct co-culture method can be used to determine the minimum inhibitory and minimum bactericidal concentrations of nanoparticles, and the direct exposure culture method can be used to assess real-time bacteriostatic versus bactericidal activity resulting from nanoparticle exposure. For nanostructured surfaces, the direct culture method is used to determine the viability of bacteria indirectly and directly in contact with nanostructured surfaces, and the focused-contact exposure method is used to examine antimicrobial activity on a specific area of a nanostructured surface. We discuss key experimental variables to consider for in vitro study design when determining the antimicrobial properties of nanoparticles and nanostructured surfaces. All these methods are relatively low cost, employ techniques that are relatively easy to master and repeatable for consistency, and are applicable to a broad range of nanostructure types and microbial species.

Knowledge about COVID-19 and perception of health safety among mexican dental students / Conocimiento sobre COVID-19 y percepción de seguridad en la salud de estudiantes mexicanos de odontología

This study aimed: 1) to investigate sources of information used by students to learn about COVID-19, 2) to investigate levels of knowledge about COVID-19 and about conditions for the treatment of patients during the COVID-19 lockdown, and 3) to evaluate students' perceptions of safety regarding their return to in-person activities at the School of Dentistry. Dental students answered a questionnaire (29 items; n=371) that explored the aims of the study, based on a Likert scale (Cronbach's alpha, 0.778). Data were tested with the Mann-Whitney U test and Kendall's Tau-c. Dental students received information about COVID-19 from the Mexican Health Ministry as their first source (45.28%). Students had good knowledge about the main characteristics of COVID-19, and 59.3% of students had excellent knowledge about the factors relevant to dental treatment of patients. Half of the students said they felt safe regarding a possible return to in-person activities at the dental school, while the other half did not. Statistically significant differences were noted between the students' scholar year and their level of knowledge (P<0.001) and between their perception of safety (very unsafe, unsafe, safe, and very safe) and scholar year (P=0.000). Dental students had good knowledge about COVID-19 and about the dental care for patients during the lockdown. Half of the dental students felt unsafe about a possible return to in-person school activities.

Los objetivos del estudio fueron 1) investigar que fuentes de información usaron los participantes para conocer sobre la COVID-19, 2) evaluar cuál es el nivel de conocimiento que tienen sobre COVID-19 y la atención a pacientes durante la contingencia, y 3) evaluar la percepción de seguridad sobre el regreso a actividades presenciales en la facultad. Estudio transversal. Se aplicó un cuestionario en línea (29 ítems; n=371) que exploró cada objetivo e incluyó una escala de Likert (Alfa de Cronbach de 0.778). Los datos fueron analizados con las pruebas de U de Mann Whitney y con Tau-c de Kendall. La mayoría de los participantes obtuvieron información sobre la COVID-19 a través de la Secretaría de Salud (45.28%), tuvieron un conocimiento bueno sobre las generalidades de la COVID-19 y el 59.3% tuvo un conocimiento excelente sobre la atención a pacientes. La mitad de los encuestados tuvo una percepción de inseguridad en un posible regreso a actividades en la facultad. Hubo diferencia estadística significativa para la asociación entre año escolar y grado de conocimiento (p<0.001) y entre la percepción en la seguridad en el regreso a actividades (muy inseguro, inseguro, seguro y muy seguro) y el grado escolar (P=0.000). Los participantes tuvieron buen conocimiento sobre las generalidades de la COVID-19 y sobre la atención a pacientes en situación de contingencia. La mitad de los EO sienten inseguridad sobre un posible regreso a actividades.

Recombinant Domain of Flagellin Promotes In Vitro a Chemotactic Inflammatory Profile in Human Immune Cells Independently of a Dendritic Cell Phenotype.

Flagellin is the major component of the flagellum in gram-positive and -negative bacteria and is also the ligand for the Toll-like receptor 5 (TLR5). The activation of TLR5 promotes the expression of proinflammatory cytokines and chemokines and the subsequent activation of T cells. This study evaluated a recombinant domain from the amino-terminus D1 domain (rND1) of flagellin from Vibrio anguillarum, a fish pathogen, as an immunomodulator in human peripheral blood mononuclear cells (PBMCs) and monocyte-derived dendritic cells (MoDCs). We demonstrated that rND1 induced an upregulation of proinflammatory cytokines in PBMCs, characterized at the transcriptional level by an expression peak of 220-fold for IL-1ß, 20-fold for IL-8, and 65-fold for TNF-α. In addition, at the protein level, 29 cytokines and chemokines were evaluated in the supernatant and were correlated with a chemotactic signature. MoDCs treated with rND1 showed low levels of co-stimulatory and HLA-DR molecules and kept an immature phenotype with a decreased phagocytosis of dextran. We probed that rND1 from a non-human pathogen promotes modulation in human cells, and it may be considered for further studies in adjuvant therapies based on pathogen-associated patterns (PAMPs).

Prevalencia del síndrome metabólico en estudiantes del Campus San Lorenzo de la Universidad Nacional de Asunción / Prevalence of metabolic syndrome in students of the Campus San Lorenzo of the National University of Asunción

Introducción. El síndrome metabólico (SM) constituye una serie de desórdenes metabólicos que en conjunto son considerados factor de riesgo para desarrollar diabetes y enfermedad cardiovascular. Objetivo. Determinar la prevalencia del SM y sus componentes en estudiantes del campus San Lorenzo dela Universidad Nacional de Asunción en el periodo 2015-2016. Materiales y métodos. Estudio observacional descriptivo de corte transverso con un muestreo por conglomerados. Se incluyeron a 163 estudiantes de facultades o institutos seleccionados. Se aplicó un cuestionario para datos sociodemográficos y actividad física, y se realizaron mediciones de circunferencia de cintura(CC), peso y altura, además de niveles séricos en ayunas de glucosa, colesterol-HDLc y triglicéridos, conjuntamente con medición de presión arterial para determinar la presencia de SM según los criterios del Panel III (NCEP-ATP-III). Los datos fueron resguardados con estricta confidencialidad. Resultados.El50,92% de los participantes era del sexo masculino, con edad promedio de 21,6± 2,4 años. El 49,7% fueron considerados sedentarios,25,16% presentó sobrepeso, 8,59% obesidad,6,75% CCelevaday16,56% hipertensión. El 2,45% y 4,9% presenta ronglicemia basal y triglicérido elevados, respectivamente, y 37,42%HDL-c bajo. La prevalencia del SM fue del 4,91%,el 52,15 % presentó al menos un factor del NCEP-ATP-III para SM Conclusión. Alrededor de la mitad de los participantes presentó al menos un factor de riesgo de SM, y los componentes más frecuentes fueron la baja concentración de HDLc, y la hipertensión arterial. Se recomienda acciones preventivas en la población juvenil basadas en actividad física y alimentación saludable. Palabras Clave: síndrome metabólico; hipertensión; sobrepeso; adulto joven

Introduction: The metabolic syndrome (MS) constitutes of a series of metabolic disorders that together are considered a risk factor to develop diabetes and cardiovascular disease.Objective.To determine the prevalence of MS and its components in students of the National University of Asunción ­San Lorenzo Campusin the 2015-2016 period. Materials and Methods.Observational descriptive cross-sectional study with a cluster sampling. A total of 163 students from selected faculties or instituteswas included. A questionnaire was applied for sociodemographic data and physical activityandwaist circumference(WC), weight and height were measured, as well as fasting serum levels of Glucose, HDLc cholesterol and triglycerides, together with blood pressure to determine the presence of MS according to the Panel III criteria (NCEP-ATP-III). All data were kept strictly confidential. Results. 50,92% of participants were male, with a mean age of 21,6± 2,4 years.49.7% were considered sedentary,25,16% presented overweight, and 8,59% obesity, 16,56%hypertension. 6,75% presentedan elevated abdominal circumference,2,45% elevated basal glycemia, 4,9% elevated Triglycerides, 37,42% low HDLc.The prevalence of MS was 4,91%and52,15% presented at least one NCEP-ATP-III factor for MS. Conclusion. Aroundhalf of the participantspresented at least one risk factor for MS, the most frequent components were low HDLc concentration and arterial hypertension.It is recommendedpreventive actions in the youth population based on physical activity and healthy eating. Key words: metabolic syndrome; hypertension; overweight; young adult

Relationship of Serum Zinc Levels with Cardiometabolic Traits in Overweight and Obese Schoolchildren from Mexico City.

Zinc (Zn) participates as a cofactor for many enzymes in the cellular metabolism, and its serum levels have been associated with different metabolic diseases, especially obesity (OB). Nevertheless, its associations are not clear in the children population. The objective of this study is to evaluate the association between serum Zn levels (SZn) with overweight/obesity status (OW/OB), as well as its cardiometabolic traits in a population of children in Mexico City. Anthropometrical data (body mass index z score (BMIz)), demographic variables (age and sex), and cardiometabolic traits (total cholesterol (TC), high-density lipoprotein cholesterol (HDLc), low-density lipoprotein cholesterol (LDLc), triglycerides (TG), fasting plasma glucose (FPG), and insulin) were analyzed in this cross-sectional study. SZn were measured by inductively coupled plasma mass spectrometry (ICP-MS). The population included 210 children from Mexico City (girls (n = 105) and boys (n = 105)) between ages 6 and 10 years. Normal-weight (NW) schoolchildren had higher SZn concentrations (66 µg/dL; IQR: 48 to 91) compared to OW or OB schoolchildren (61 µg/dL; IQR: 45 to 76). The data showed a significant negative association between SZn and BMIz without sex exclusion (r = - 0.181 and p = 0.009). The boy's population did not show an association between the SZn and BMIz compared to the girl's population which showed a significant negative association (r = - 0.277 and p = 0.004). In addition, other associations were found between SZn and TC (boys (r = 0.214 and p = 0.025), LDLc (boys (r = 0.213 and p = 0.029), and TG (girls (r = - 0.260 and p = 0.007)). Moreover, 38.6% of the total children in our population study had Zn deficiency (ZnD). NW schoolchildren had higher SZn concentrations compared to OW or OB schoolchildren. A diet low in Zn can be a factor to evaluate in the development of childhood OB in Mexico. However, further studies need to be performed on the children Mexican population to replicate and confirm our findings.

Redescription and neotype designation of Suphis fluviatilis Guignot, 1948 (Coleoptera: Dytiscoidea: Noteridae) and notes on other species of the genus.

Suphis fluviatilis Guignot, 1948 was described based on a single female specimen, and according to the author, the type was deposited in the Museum National dHistoire Naturelle (Paris, France). However, the diagnostic features of the specimen deposited under this name and provided with the respective labels deviate considerably from those given by Guignot in his original description. It is shown that this specimen belongs to Suphis notaticollis Zimmermann, 1921, confirming previous observations by Luis Grosso in 1980. Thus, a neotype of S. fluviatilis is designated to avoid instability of the nomenclature by the impending synonymy of S. fluviatilis with S. notaticollis. Suphis fluviatilis is redescribed in detail, including illustrations of the main diagnostic characters. The species is compared with other Neotropical Suphis species, in particular with S. notaticollis. Additionally, the male genitalia of Suphis intermedius Rgimbart, 1903 are described for the first time, and a first record from Paraguay is given.

Autocuidado del cuidador informal de personas mayores en algunos países de Latinoamérica: Revisión descriptiva

Resumen: Introducción: La familia es la responsable del cuidado a la persona mayor, lo que da origen al cuidador informal. Objetivo: Describir el autocuidado del cuidador informal de personas mayores en algunos países de Latinoamérica. Metodología: Revisión descriptiva en las bases de datos PubMed, Scopus, SciELO, Web of Science, Redalyc y Dialnet, de artículos científicos a texto completo de los últimos 13 años (2009-2022) en idioma español, inglés y portugués; complementariamente se buscaron documentos referentes al tema en páginas web de instituciones nacionales de países latinoamericanos. Resultados: El análisis de los 25 artículos científicos y 4 documentos seleccionados permitieron identificar 4 ejes: conceptos de cuidado, cuidador y tipos de cuidadores; salud del cuidador informal de la persona mayor; base teórica del autocuidado, e implementación de programas para cuidar al cuidador en algunos países latinoamericanos. Conclusiones: Se evidencia que el autocuidado de los cuidadores de personas mayores está disminuido, lo que afecta directamente la salud de este. Varios países de Latinoamérica apoyan al cuidador informal, sin embargo, todavía hay mucho por hacer por las personas que cumplen la labor del cuidado.

Resumo: Introdução: A família é responsável por cuidar do idoso, dando origem ao cuidador informal. Objetivo: Descrever o autocuidado do cuidador informal de idosos em alguns países da América Latina. Metodologia: Revisão descritiva nas bases de dados PubMed, Scopus, SciELO, Web of Science, Redalyc e Dialnet; artigos científicos em texto completo dos últimos 13 anos (2009-2022) em espanhol, inglês e português; foram pesquisados ​​documentos complementares referentes ao assunto em páginas da Web de instituições nacionais de países da América Latina. Resultados: A análise dos 25 artigos científicos e 4 documentos selecionados permitiu identificar 4 eixos: conceitos de cuidado, cuidador e tipos de cuidadores; saúde do cuidador informal do idoso; base teórica do autocuidado e implementação de programas de cuidado ao cuidador em alguns países da América Latina. Conclusões: É evidente que o autocuidado dos cuidadores de idosos está diminuído, afetando diretamente sua saúde. Vários países da América Latina apoiam o cuidador informal, porém, ainda há muito a ser feito pelas pessoas que realizam o trabalho de cuidar.

Abstract: Introduction: The family is responsible for the care of the elderly, giving rise to the informal caregiver. Objective: To describe the self-care of the informal caregiver of the elderly in some Latin American countries. Methodology: Descriptive review, on the following databases: PubMed, Scopus, SciELO, Web of Science, Redalyc and Dialnet; analyzing full-text scientific articles of the last 13 years (2009-2022) in Spanish, English and Portuguese. Complementary documents related to the subject were searched on Web pages of national institutions of Latin American countries. Results: The analysis of the 25 scientific articles and 4 selected documents allowed to identify 4 axes: concepts of care, caregiver and types of caregivers; health of the informal caregiver of the elderly; theoretical basis of self-care and implementation of programs to care for the caregiver in some Latin American countries. Conclusions: It is evident that the self-care of caregivers of older people is decreased, directly affecting the health of this. Several Latin American countries support the informal caregiver, however, there is still much to be done for caregivers.

[Distribution of triglycerides and glucose (TyG) index and homeostasis model assessment insulin resistance for the evaluation of insulin sensitivity on late adolescence in Mexicans]. / Distribución del índice triglicéridos y glucosa (TyG) y el modelo homeostático para la evaluación de la resistencia a la insulina en la adolescencia tardía en mexicanos.

Introduction: Introduction: when peripheral tissues don't respond well to insulin action, it is defined as insulin resistance (IR). Many methods and indices are available for the estimation of IR, among them the homeostasis model assessment of insulin resistance (HOMA-IR) involves fasting plasma glucose and insulin. Nevertheless, the TyG index has a methodological advantage over the HOMA-IR because it requires only measurements provided by routine laboratory tests. Aim: distribution asessment of the HOMA-IR and TyG indexes in the sample. Also, to determine the predictive capacity of HOMA-IR, using TyG cutoff point as IR-positive diagnostic test. Materials and methods: a cross-sectional analytical study with 1686 participants aged 18 to 21 years from the state of San Luis Potosí, Mexico. Anthropometric assessment involves variables of weight and height. Fasting glucose, insulin and triglyceride concentrations were quantified. In addition, a questionnaire was carried out to know the hereditary family history and the presence of noncommunicable diseases (NCDs). Student's t-test was used to assess the differences in mean statistics between males and females. A receiver operating characteristic (ROC) curve was applied to examine the potential of HOMA-IR to identify IR. Results: 56 % of the study adolescents were females and 44 % were males; mean BMI was 22.62 ± 3.21 kg/m2. In the total sample mean serum glucose, insulin, and triglyceride concentrations were 89.48 ± 9.84 mg/dL, 6.26 ± 5.04 µU/mL, and 95.64 ± 55.78 mg/dL, respectively. A prevalence of 28.2 % of IR was determined, evaluated with the cut-off points for the TyG index. Subsequently, Receiver Operator Curves (ROC) were performed to evaluate the predictive capacity of HOMA-IR. The most outstanding cut-off value was 1.08 for the HOMA-IR index, reaching a sensitivity of 66 % and a specificity of 53 %. The prevalence of HOMA-IR greater than or equal to 1.18 was 47 % in the total population, 19.3 % in males and 28.5 % in females Conclusions: HOMA-IR and TyG can be useful diagnostic parameters for the assessment of IR in late adolescence. To provide a health guide for IR, we propose that a HOMA-IR target value ≤ 1.08 should be considered.

Introducción: Introducción: cuando los tejidos periféricos tienen una incapacidad para responder a la acción de la insulina se denomina resistencia a la insulina (RI). Existen diferentes métodos para la identificación de la RI; uno de estos es el índice HOMA-IR, que utiliza los parámetros de laboratorio, glucosa e insulina en ayunas. El índice triglicéridos y glucosa (TyG) presenta la ventaja de solo necesitar análisis de laboratorio de rutina. Objetivo: evaluación de la distribución de los índices HOMA-IR y TyG en la población, así como determinar la capacidad predictiva del índice HOMA-IR utilizando el TyG como prueba diagnóstica para la RI. Materiales y métodos: estudio analítico transversal con 1686 participantes de 18 a 21 años del estado de San Luis Potosí. Se tomaron variables antropométricas de peso y talla y se cuantificó la concentración de glucosa, insulina y triglicéridos en ayuno. Además, se realizó un cuestionario para conocer los antecedentes heredofamiliares y la presencia de enfermedades no transmisibles (ENT). Para la comparación entre mujeres y hombres se realizó una prueba de la t de Student y se realizaron curvas operador receptor (COR) para determinar los valores de corte del HOMA-IR. Resultados: el 56 % de la población fueron mujeres y el 44 % hombres; la media del IMC fue de 22,62 ± 3,21 kg/m2. En la población total de estudio, la media de la concentración sérica de glucosa, insulina y triglicéridos fue de 89,48 ± 9,84 mg/dL, 6,26 ± 5,04 µU/mL y 95,64 ± 55,78 mg/dL, respectivamente. Se determinó una prevalencia del 28,2 % de la RI evaluada con los puntos de corte para el índice TyG. Posteriormente se realizaron curvas operador receptor (COR) para evaluar la capacidad predictiva del HOMA-IR. El valor de corte más destacado fue de 1,08 para el índice HOMA-IR, alcanzando una sensibilidad del 66 % y una especificidad del 53 %. La prevalencia del HOMA-IR mayor o igual a 1,18 fue del 47 % en la población total, del 19,3 % en los hombres y del 28,5 % en las mujeres. Conclusiones: los índices HOMA-IR y TyG pueden ser parámetros de utilidad diagnóstica para la valoración de la RI en la adolescencia tardía. Con el objetivo de brindar una guía de salud para la RI, proponemos que se debe considerar como objetivo un valor de HOMA-IR ≤ 1,08.

Honokiol and Alpha-Mangostin Inhibit Mayaro Virus Replication through Different Mechanisms.

Mayaro virus (MAYV) is an emerging arbovirus with an increasing circulation across the Americas. In the present study, we evaluated the potential antiviral activity of the following natural compounds against MAYV and other arboviruses: Sanguinarine, (R)-Shikonin, Fisetin, Honokiol, Tanshinone IIA, and α-Mangostin. Sanguinarine and Shikonin showed significant cytotoxicity, whereas Fisetin, Honokiol, Tanshinone IIA, and α-Mangostin were well tolerated in all the cell lines tested. Honokiol and α-Mangostin treatment protected Vero-E6 cells against MAYV-induced damage and resulted in a dose-dependent reduction in viral progeny yields for each of the MAYV strains and human cell lines assessed. These compounds also reduced MAYV viral RNA replication in HeLa cells. In addition, Honokiol and α-Mangostin disrupted MAYV infection at different stages of the virus life cycle. Moreover, Honokiol and α-Mangostin decreased Una, Chikungunya, and Zika viral titers and downmodulated the expression of E1 and nsP1 viral proteins from MAYV, Una, and Chikungunya. Finally, in Honokiol- and α-Mangostin-treated HeLa cells, we observed an upregulation in the expression of type I interferon and specific interferon-stimulated genes, including IFNα, IFNß, MxA, ISG15, OAS2, MDA-5, TNFα, and IL-1ß, which may promote an antiviral cellular state. Our results indicate that Honokiol and α-Mangostin present potential broad-spectrum activity against different arboviruses through different mechanisms.

Distribución del índice triglicéridos y glucosa (TyG) y el modelo homeostático para la evaluación de la resistencia a la insulina en la adolescencia tardía en mexicanos / Distribution of triglycerides and glucose (TyG) index and homeostasis model assessment insulin resistance for the evaluation of insulin sensitivity on late adolescence in Mexicans

Introducción: cuando los tejidos periféricos tienen una incapacidad para responder a la acción de la insulina se denomina resistencia a la insulina (RI). Existen diferentes métodos para la identificación de la RI; uno de estos es el índice HOMA-IR, que utiliza los parámetros de laboratorio, glucosa e insulina en ayunas. El índice triglicéridos y glucosa (TyG) presenta la ventaja de solo necesitar análisis de laboratorio de rutina. Objetivo: evaluación de la distribución de los índices HOMA-IR y TyG en la población, así como determinar la capacidad predictiva del índice HOMA-IR utilizando el TyG como prueba diagnóstica para la RI. Materiales y métodos: estudio analítico transversal con 1686 participantes de 18 a 21 años del estado de San Luis Potosí. Se tomaron variables antropométricas de peso y talla y se cuantificó la concentración de glucosa, insulina y triglicéridos en ayuno. Además, se realizó un cuestionario para conocer los antecedentes heredofamiliares y la presencia de enfermedades no transmisibles (ENT). Para la comparación entre mujeres y hombres se realizó una prueba de la t de Student y se realizaron curvas operador receptor (COR) para determinar los valores de corte del HOMA-IR. (AU)

Introduction: when peripheral tissues don't respond well to insulin action, it is defined as insulin resistance (IR). Many methods and indices are available for the estimation of IR, among them the homeostasis model assessment of insulin resistance (HOMA-IR) involves fasting plasma glucose and insulin. Nevertheless, the TyG index has a methodological advantage over the HOMA-IR because it requires only measurements provided by routine laboratory tests. Aim: distribution asessment of the HOMA-IR and TyG indexes in the sample. Also, to determine the predictive capacity of HOMA-IR, using TyG cutoff point as IR-positive diagnostic test. Materials and methods: a cross-sectional analytical study with 1686 participants aged 18 to 21 years from the state of San Luis Potosí, Mexico. Anthropometric assessment involves variables of weight and height. Fasting glucose, insulin and triglyceride concentrations were quantified. In addition, a questionnaire was carried out to know the hereditary family history and the presence of noncommunicable diseases (NCDs). Student's t-test was used to assess the differences in mean statistics between males and females. A receiver operating characteristic (ROC) curve was applied to examine the potential of HOMA-IR to identify IR. (AU)

Anti-glomerular Basement Membrane Glomerulonephritis: A Study in Real Life.

Introduction: Anti-glomerular basement membrane (anti-GBM) disease is a severe entity with few therapeutic options including plasma exchange and immunosuppressive agents. The aim of this study was to analyze the clinical and pathological features that predict the evolution of end-stage kidney disease (ESKD) and the kidney survival in a cohort of patients with anti-GBM disease with renal involvement in real life. Methods: A retrospective multicentre observational study including 72 patients from 18 nephrology departments with biopsy-proven anti-GBM disease from 1999 to 2019 was performed. Progression to ESKD in relation to clinical and histological variables was evaluated. Results: Creatinine at admission was 8.6 (± 4) mg/dL and 61 patients (84.7%) required dialysis. Sixty-five patients (90.3%) underwent plasma exchange. Twenty-two patients (30.6%) presented pulmonary hemorrhage. Kidney survival was worse in patients with creatinine levels > 4.7 mg/dL (3 vs. 44% p < 0.01) and in patients with > 50% crescents (6 vs. 49%; p = 0.03). Dialysis dependence at admission and creatinine levels > 4.7 mg/dL remained independent significant predictors of ESKD in the multivariable analysis [HR (hazard ratio) 3.13 (1.25-7.84); HR 3 (1.01-9.14); p < 0.01]. The discrimination value for a creatinine level > 4.7 mg/dL and 50.5% crescents had an area under the curve (AUC) of 0.9 (95% CI 0.82-0.97; p < 0.001) and 0.77 (95% CI 0.56-0.98; p = 0.008), respectively. Kidney survival at 1 and 2 years was 13.5 and 11%, respectively. Patient survival at 5 years was 81%. Conclusion: In real life, patients with severe anti-GBM disease (creatinine > 4.7 mg/dL and > 50% crescents) remained with devastating renal prognosis despite plasma exchange and immunosuppressive treatment. New therapies for the treatment of this rare renal disease are urgently needed.

Associations between bacterial communities and microplastics from surface seawater of the Northern Patagonian area of Chile.

The presence of microplastics in oceans and coastlines has increased during recent years due anthropogenic activities and represents a serious environmental problem. The establishment and assembly of microbial communities in these microplastics, specifically located near aquaculture activities, is not well understood. In this study, we analyzed unique and core members of bacterial communities attached to microplastics collected from three coastal environments of the South Pacific, which represent low, medium and high anthropogenic activity derived from the aquaculture industry. Microplastics were analyzed with Fourier-transform infrared spectroscopy, scanning electron microscopy, and next-generation sequencing to assess the prevailing microplastics types, and to characterize microbial communities attached to them. We identified four main types of microplastics (polypropylene, polyethylene, nylon and polystyrene) and 3102 Operational Taxonomic Units (OTUs) at the sampled sites, which were dominated by the phylum Cyanobacteria, Bacteroidetes and Proteobacteria (mainly Alpha and Gammaproteobacteria). Similarity index analysis showed that bacterial communities in microplastics differed from those found in the surrounding seawaters, and also that they varied among locations, suggesting a role of the environment and level of anthropogenic activities on the plastisphere taxa. Despite this difference, 222 bacterial OTUs were shared among the three sites representing between 34 and 51% of OTUs of each sampled site, and thus constituted a core microbiome of microplastics. Comparison of the core microbiome with bacterial communities of the surrounding seawater suggested that the plastisphere constituted a selective habitat for diverse microbial communities. Computational predictions also provided evidence of significantly enriched functions in the core microbiome. Co-occurrence networks revealed that putative ecological interactions among microplastics OTUs was dominated by positive correlations. To the best of our knowledge, this is the first study that evaluated the composition of microbial communities found in microplastics from the Patagonia region of the Southern Pacific Ocean.

Wildmeat consumption and child health in Amazonia.

Consuming wildmeat may protect against iron-deficiency anemia, a serious public health problem globally. Contributing to debates on the linkages between wildmeat and the health of forest-proximate people, we investigate whether wildmeat consumption is associated with hemoglobin concentration in rural and urban children (< 5 years old) in central Brazilian Amazonia. Because dietary practices mediate the potential nutritional benefits of wildmeat, we also examined whether its introduction into children's diets is influenced by rural/urban location or household socio-economic characteristics. Sampling 610 children, we found that wildmeat consumption is associated with higher hemoglobin concentration among the rural children most vulnerable to poverty, but not in the least vulnerable rural, or urban children. Rural caregivers share wildmeat with children earlier-in-life than urban caregivers, potentially because of cultural differences, lower access to domesticated meat, and higher wildmeat consumption by rural households (four times the urban average). If wildmeat becomes unavailable through stricter regulations or over-harvesting, we predict a ~ 10% increased prevalence of anemia among extremely poor rural children. This modest protective effect indicates that ensuring wildmeat access is, alone, insufficient to control anemia. Sustainable wildlife management could enhance the nutritional benefits of wildlife for vulnerable Amazonians, but reducing multidimensional poverty and improving access to quality healthcare are paramount.

Acute Chagas Disease Caused by Trypanosoma cruzi TcIV and Transmitted by Panstrongylus geniculatus: Molecular Epidemiological Insights Provided by the First Documented Autochthonous Case in Rondônia, Southwestern Amazonia, Brazil.

Recurrent outbreaks of oral infection and isolated cases characterize the new epidemiological scenario of Chagas disease (CD) in the Brazilian Amazon. Acute Chagas disease (ACD) is common in Pará and Amazonas, Northeastern and Northwestern Brazilian Amazonia. In the present study, we describe the first molecularly characterized autochthonous case of ACD in Rondônia, Southwestern Amazonia. The patient, a 39-year-old male resident in the small city of Cujubim, presented typical ACD symptoms: fever, asthenia, myalgia, progressive dyspnea, swelling of the legs, and tiredness at minimal efforts, all compatible with ACD and indicative of cardiac involvement. A thick blood drop test revealed trypomastigote forms of Trypanosoma cruzi genotyped as TcIV. An epidemiological investigation ruled out oral infection, and support for vectorial transmission included the finding of Panstrongylus geniculatus positive for T. cruzi (TcIII and TcIV) inside the tent used by the patient when harvesting forest timber, and a circular cutaneous lesion resembling a chagoma of inoculation. Treatment with benznidazole led to blood parasite clearance as confirmed by molecular tests. Altogether, our findings fitted well into the ecological scenario where deforestation and colonization of forested areas represent an important risk factor to the adaptation of P. geniculatus to human habitats, favoring vectorial transmission of CD in the Amazonian region.