Pregnancies through oocyte donation. A mini review of pathways involved in placental dysfunction.

Pregnancies resulting from assisted reproductive techniques (ART) are increasingly prevalent worldwide. While most pregnancies conceived through in-vitro fertilization (IVF) progress without complications, mounting evidence suggests that these pregnancies are at a heightened risk of adverse perinatal outcomes. Specifically, IVF pregnancies involving oocyte donation have garnered attention due to numerous reports indicating an elevated risk profile for pregnancy-related complications within this subgroup of patients. The precise mechanisms contributing to this increased risk of complications remain incompletely understood. Nonetheless, it is likely that they are mediated by an abnormal immune response at the fetal-maternal interface. Additionally, these outcomes may be influenced by baseline patient characteristics, such as the etiology of infertility, absence of corpus luteum, and variations in endometrial preparation protocols, among other factors. This review aims to succinctly summarize the most widely accepted mechanisms that potentially contribute to the onset of placental dysfunction in pregnancies conceived through oocyte donation.

Metal Exposure in Arica, Chile: Examining Toxic Elements / Análisis de exposición a metales en Arica, Chile: niveles de elementos tóxicos

BACKGROUND: Bioaccumulation of toxic metals in the population is associated with adverse health effects. Although some elements are essential for humans, high levels of exposure can be dangerous. OBJECTIVE: To describe the levels of Inorganic Arsenic (AsIn), Cadmium (Cd), Chromium (Cr), and Mercury (Hg) in urine, and Lead (Pb) in blood in the population of Arica, Chile. METHODOLOGY: Descriptive study. Beneficiaries of the Health Surveillance Program of Law 20.590 in sites of higher risk of exposure in the commune of Arica were considered eligible. The results of biological samples to measure their concentrations of AsIn, Cd, Cr, Hg in urine, and Pb in blood between August 2016 and May 2021 are described. RESULTS: 9520 samples from a population with a mean age of 40.5 years were studied. 4.21% of the adult population and 6.57% of the children had AsIn values above 35 μg/L, while at least 95 % of the total samples had levels below 33 μg/L. At least 90 % of the samples had Cd levels below 1.1 μg/L, and 8.44 % had Cd levels above 2 μg/L, higher in males (11.67%). There were no values above the reference in children. 99.77% and 99.33% had Cr and Pb values below the reference limit, respectively (using the lowest reference range established by Chile Ministry of Health (MINSAL) < 5 μg/L). Children did not present risk values for Cr, and 0.16% presented Pb concentrations between 5-10 μg/dL. All samples presented Hg concentrations below risk levels (< 10 μg/L). CONCLUSIONS: The results of this study suggest that a small percentage of the samples analyzed in the beneficiary population of Arica register metal concentration levels above national reference levels established by MINSAL, mainly AsIn, Cd, and Pb. It is essential to continue biomonitoring to reduce and prevent exposure to these metals, which can have harmful effects on human health.

ANTECEDENTES: La bioacumulación de metales en la población está asociada a efectos adversos y pueden ser peligrosos. OBJETIVO: Describir los niveles de Arsénico Inorgánico (AsIn), Cadmio (Cd), Cromo (Cr), Mercurio (Hg) y Plomo (Pb) en la población de Arica, Chile. MATERIALES Y MÉTODOS: Estudio descriptivo. Se incluyeron todas las personas beneficiarias del Programa de Vigilancia de Salud de la Ley 20.590 en sitios de riesgo de mayor exposición en la comuna de Arica entre agosto 2016 y mayo 2021. RESULTADOS: Se estudiaron 9.520 muestras provenientes de una población con una edad media de 40.5 años. 4.21% de la población adulta y el 6.57% de los niños presentaron valores de AsIn superiores a 35 μg/L y al menos el 95% de las muestras totales tenía niveles inferiores a 33 μg/L. Más del 90 % de las muestras tuvieron niveles de Cd menores a 1.1 μg/L y un 8.44% registró niveles de Cd superiores 2 μg/L. El 99.77% y 99.33% exhibieron valores normales de Cr y Pb, respectivamente. Todas las muestras presentaron concentraciones de Hg por debajo de los niveles de riesgo (< 10 μg/L). CONCLUSIONES: Los resultados sugieren que un porcentaje pequeño de la población de Arica registra niveles de concentración de metales por sobre niveles de referencia nacional establecidos por el Ministerio de Salud de Chile, principalmente de AsIn, Cd y Pb. Es importante continuar con la vigilancia para reducir y prevenir la exposición a estos metales, que pueden generar efectos nocivos en la salud humana.

Carbon Fibers Prepared via Solution Plasma-Generated Seeds.

Carbon fibers are materials with potential applications for CO2 capture due to their porous structure and high surface areas. Nevertheless, controlling their porosity at a microscale remains challenging. The solution plasma (SP) process provides a fast synthesis route for carbon materials when organic precursors are used. During the discharge and formation of carbon materials in solution, a soot product-denominated solution plasma-generated seeds (SPGS) is simultaneously produced at room temperature and atmospheric pressure. Here, we propose a preparation method for carbon fibers with different and distinctive morphologies. The control over the morphology is also demonstrated by the use of different formulations.

Metal Exposure in Arica, Chile: Examining Toxic Elements.

BACKGROUND: Bioaccumulation of toxic metals in the population is associated with adverse health effects. Although some elements are essential for humans, high levels of exposure can be dangerous. OBJECTIVE: To describe the levels of Inorganic Arsenic (AsIn), Cadmium (Cd), Chromium (Cr), and Mercury (Hg) in urine, and Lead (Pb) in blood in the population of Arica, Chile. METHODOLOGY: Descriptive study. Beneficiaries of the Health Surveillance Program of Law 20.590 in sites of higher risk of exposure in the commune of Arica were considered eligible. The results of biological samples to measure their concentrations of AsIn, Cd, Cr, Hg in urine, and Pb in blood between August 2016 and May 2021 are described. RESULTS: 9520 samples from a population with a mean age of 40.5 years were studied. 4.21% of the adult population and 6.57% of the children had AsIn values above 35 µg/L, while at least 95 % of the total samples had levels below 33 µg/L. At least 90 % of the samples had Cd levels below 1.1 µg/L, and 8.44 % had Cd levels above 2 µg/L, higher in males (11.67%). There were no values above the reference in children. 99.77% and 99.33% had Cr and Pb values below the reference limit, respectively (using the lowest reference range established by Chile Ministry of Health (MINSAL) < 5 µg/L). Children did not present risk values for Cr, and 0.16% presented Pb concentrations between 5-10 µg/dL. All samples presented Hg concentrations below risk levels (< 10 µg/L). CONCLUSIONS: The results of this study suggest that a small percentage of the samples analyzed in the beneficiary population of Arica register metal concentration levels above national reference levels established by MINSAL, mainly AsIn, Cd, and Pb. It is essential to continue biomonitoring to reduce and prevent exposure to these metals, which can have harmful effects on human health.

Low molecular weight heparin in one or two doses for the initial treatment of venous thromboembolic disease?

The preferred dosification for low molecular weight heparins is in two doses for most patients with venous thromboembolic disease. A daily dose would make treatment simpler, less expensive and more comfortable while retaining a similar benefit and safety. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified two systematic reviews including five randomized trials. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded it is not clear whether the risk of recurrence differs between the two alternatives because the certainty of the evidence is very low, and that administering low molecular weight heparin in two doses might be associated to little or no difference in the risk of major bleeding and mortality.

La heparina de bajo peso molecular administrada cada 12 horas es el tratamiento inicial de elección para muchos pacientes con enfermedad tromboembólica. Sin embargo, la administración cada 24 horas podría facilitar el manejo, disminuir costos y mejorar el confort del paciente manteniendo los mismos beneficios y seguridad. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos dos revisiones sistemáticas que en conjunto incluyen cinco estudios aleatorizados. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que la certeza de la evidencia es muy baja para determinar si el riesgo de recurrencia es similar entre ambas opciones y que la administración en dos dosis al día podría asociarse a poca o nula disminución en el riesgo de hemorragia mayor y mortalidad.

Does aspirin reduce recurrence after completing anticoagulant treatment for an idiopathic thromboembolic event?

Idiopathic thromboembolic disease presents a high risk of recurrence. There is controversy about the effects of aspirin in reducing this risk after the completion of anticoagulant treatment. Searching in Epistemonikos database, which screens 30 databases, we identified four systematic reviews that together include two randomized trials. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded that aspirin administered after having completed anticoagulation reduces the risk of recurrence, probably without importantly increasing the risk of hemorrhage.

La enfermedad tromboembólica idiopática presenta un alto riesgo de recurrencia. Existe controversia respecto a la utilidad de la aspirina para disminuir la recurrencia luego de haber completado el tratamiento anticoagulante. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos cuatro revisiones sistemáticas que en conjunto incluyen dos estudios aleatorizados. Combinamos la evidencia utilizando metanálisis y generamos una tabla con síntesis de resultados según la metodología GRADE. Concluimos que la indicación de aspirina luego de haber completado el tratamiento anticoagulante disminuye la probabilidad de recurrencia y probablemente no aumenta de manera importante el riesgo de hemorragia.

Determinantes de adherencia al tratamiento antihipertensivo de adultos ≥ 35 años de edad / Determinants of adherence to antihypertensive treatment in adults ≥ 35 years of age

Introducción: La hipertensión es una condición prevalente y un factor de riesgo que conduce a morbi-mortalidad alrededor del mundo. El objetivo de este estudio es establecer los determinantes de adherencia al tratamiento hipertensivo en adultos sobre 35 años de edad de Pasto, Colombia. Método: Un estudio transversal fue llevado a cabo para establecer los determinantes de adherencia a la terapia farmacológica antihipertensiva en 128 adultos del "Centro de Salud Lorenzo de Aldana". La evaluación de la adherenci��0ue hecha a través del test de Morisky-Green versión en Español. Un análisis descriptivo fue usado para variables demográficas y una regresión logística fue ejecutada para calcular un resultado dicotómico para los determinantes de adherencia. Resultados: La muestra de estudio consistió en 40 (31,3%) hombres y 88 (68,8%) mujeres pacientes hipertensos. El porcentaje de adherencia a la medicación fue 41.4%. Los pacientes hombres tenían mayor probabilidad de estar adheridos al tratamiento hipertensivo cuando ellos usaban más de un medicamento antihipertensivo, tal como inhibidores de la enzima convertidora de angiotensina, bloqueadores de los canales de calcio y diuréticos (OR:4,16; IC al 95%:0,34-5,61), ellos estaban casados (OR:2,97; IC al 95%: 0,72- 11,73) y ellos estaban hospitalizados (OR:1,92; IC al 95%: 0,11- 33,30). Sin embargo, las pacientes mujeres cuando ellas no tenían comorbilidad (OR:4,27; IC al 95%: 0,81-22,49), ellas estaban entre 35 y 45 años (OR:4.0; IC al 95%:0,39-40,05) y ellas eran solteras (OR:2,56; IC al 95%:1,03-6,38) fueron más adherentes. Conclusiones: Estos hallazgos sugieren que los determinantes de la adherencia a tratamientos antihipertensivos podrían depender del género.

Introduction: Hypertension is a prevalent condition and a risk factor for morbidity and mortality around the world. The aim of this study is to establish the adherence determinants to antihypertensive treatment in adults over 35 from Pasto, Colombia. Methods: A cross-sectional study was conducted to establish the adherence determinants to antihypertensive pharmacotherapy in 128 adults at "Centro de Salud Lorenzo de Aldana". The adherence evaluation was made through the Morisky-Green test in its Spanish version. A descriptive analysis was used for demographic variables, and a logistic regression was performed to calculate a dichotomous outcome by adherence determinants. Results: The study sample consisted of 40 (31.3%) men and 88 (68.8%) women who are hypertensive patients. The percentage of adherence to medication was 41.4%. Male patients were more likely to be adherent to hypertensive treatment when they used more than one antihypertensive drugs such as angiotensin converting enzyme inhibitors, calcium channel blockers and diuretics (OR:4.16; 95% CI:0.34, 5.61), when they were married (OR:2.97; 95% CI:0.72, 11.73), and when they were hospitalized (OR:1.92; 95 % CI:0.11, 33.30). However, female patients were adherent when they did not have comorbidity (OR: 4.27; 95% CI: 0.81, 22.49), when they were 35 to 45 years old (OR:4.0; 95% CI:0.39, 40.05), and when they were single (OR:2.56; 95% CI:1.03, 6.38). Conclusions: These findings suggest that adherence determinants to antihypertensive treatment may depend on gender.

[The effectiveness of a 0.1% polyhexanide gel]. / Efectividad de un gel de polihexanida al 0,1%.

In recent years, there has been an increase in the number of studies dealing with chronic wound infections which have led to the use of new terms such as critical colonization or bacterial films which, together with a patient's base conditions, are closely related to the cicatrisation process, especially regarding the stagnation or regression of this process. For this reason an evaluation on the effectiveness of Prontosan Gel, a 0.1% polyhexanide gel, was carried out to see how this gel met the recommendations for cleansing wounds provided by the National Group which Studies and Counsels Health Professionals regarding Bed Sores and Chronic Wounds (GNEAUPP) and by the Agency for Health Care Policy and Research (AHCPR) for the control of bacterial build-up in chronic wounds. The data obtained in the final evaluation of the lesions studied have been: a reversal in positive cultures (p=0.004); an improvement in the stagnation of the cicatrisation process (p=0.000); reduction in the size of the wound (p=0.013); an improvement in the percentage of granulation tissue (p=0.001); an improvement in the percentage of slough in the bed of the wound (p=0.002); an improvement in the presence of exudation (p=0.008); an improvement in the presence of purulent exudation (p=0.005); an improvement in the condition of skin nearby the wound (p=0.021); an improvement in pain control (p=0.049); an improvement in erythema in nearby skin (p=0.004); an improvement in edema in skin nearby the wound (p=0.000); an improvement in the heat in the skin nearby the wound (p=0.004); and an improvement in the smell (p=0.029). To use this product propitiates the cleansing of unwanted slough in the bed of a wound; favors bacterial control and a reduction of bio-films and the care of local infection in wounds; to use this product stimulates granulation, favoring the control of stagnant ulcers, without evolution, in their cicatrisation process; the use of this product has no toxic effects on new-formed tissue; this product aids wound cicatrisation reducing the time needed for a wound to close; this product increases a patient's life quality by controlling pain, smell and the condition of surrounding tissues (edema, erythema, maceration...).

Efectividad de un gel de polihexanida al 0, 1%. Evaluación clínica frente a las recomendaciones de limpieza y desbridamiento del gneaupp y la ahcpr en el control de la carga bacteriana en heridas crónicas / The effectiveness of a 0.1%. Polyhexanide gel clinical evaluation based on the cleansing and debridement recommendations by the national group which studies and counsels health professionals regarding bed sores and chronic wounds (GNEAUPP) and by the agency for health care policy and research (AHCPR) for the control of bacterial build-up in chronic wounds

Durante los últimos años han aumentado los estudios sobre la infección de las heridas crónicas, dando lugar a nuevos términos como el de colonización crítica o biofilms bacterianos que, junto con las condiciones de base del paciente, están íntimamente relacionados con el proceso de cicatrización, especialmente con el estancamiento o retroceso del mismo. Por ello se evalúa la efectividad de un producto de polihexanida 0,1% (Prontosan Gel®) frente a las recomendaciones sobre la limpieza de heridas del GNEAUPP y la AHCPR (Agency for Health Care Policy and Research) en el control de la carga bacteriana de las heridas crónicas. Los datos obtenidos en la valoración final de las lesiones han sido: reversión de cultivos positivos (p=0,004); mejora en el estancamiento del proceso de cicatrización (p=0,000); disminución de la superficie de la lesión (p=0,013); mejora del porcentaje de tejido de granulación (p=0,001), del porcentaje de esfacelos en el lecho de la herida (p=0,002), de la presencia de exudado (p=0,008), de exudado purulento (p=0,005), del estado de la piel perilesional (p=0,021); control del dolor (p=0,049), del eritema de la piel perilesional (p=0,004), del edema de la piel perilesional (p=0,000), del calor de la piel perilesional (p=0,004) y del olor (p=0,029). La utilización de este producto propicia la limpieza del lecho de la herida de esfacelos desvitalizados; favorece el control bacteriano y la reducción de los biofilms y el manejo de la infección local de las lesiones; estimula la granulación, favoreciendo el control de las úlceras estancadas, sin evolución, en su proceso de cicatrización, sin efectos tóxicos sobre el tejido de neoformado; beneficia la cicatrización de las lesiones disminuyendo el tiempo de cierre; aumenta la calidad al controlar el dolor, olor y el estado de los tejidos circundantes (edema, eritema, maceración...)(AU)

In recent years, there has been an increase in the number of studies dealing with chronic wound infections which have led to the use of new terms such as critical colonization or bacterial films which, together with a patient’s base conditions, are closely related to the cicatrisation process, especially regarding the stagnation or regression of this process. For this reason an evaluation on the effectiveness of Prontosan Gel®, a 0.1% polyhexanide gel, was carried out to see how this gel met the recommendations for cleansing wounds provided by the National Group which Studies and Counsels Health Professionals regarding Bed Sores and Chronic Wounds (GNEAUPP) and by the Agency for Health Care Policy and Research (AHCPR) for the control of bacterial build-up in chronic wounds. The data obtained in the final evaluation of the lesions studied have been: a reversal in positive cultures (p=0.004); an improvement in the stagnation of the cicatrisation process (p=0.000); reduction in the size of the wound (p=0.013); an improvement in the percentage of granulation tissue (p=0.001); an improvement in the percentage of slough in the bed of the wound (p=0.002); an improvement in the presence of exudation (p=0.008); an improvement in the presence of purulent exudation (p=0.005); an improvement in the condition of skin nearby the wound (p=0.021); an improvement in pain control (p=0.049); an improvement in erythema in nearby skin (p=0.004); an improvement in edema in skin nearby the wound (p=0.000); an improvement in the heat in the skin nearby the wound (p=0.004); and an improvement in the smell (p=0.029). To use this product propitiates the cleansing of unwanted slough in the bed of a wound; favors bacterial control and a reduction of bio-films and the care of local infection in wounds; to use this product stimulates granulation, favoring the control of stagnant ulcers, without evolution, in their cicatrisation process; the use of this product has no toxic effects on new-formed tissue; this product aids wound cicatrisation reducing the time needed for a wound to close; this product increases a patient’s life quality by controlling pain, smell and the condition of surrounding tissues (edema, ery-thema, maceration...)(AU)