Giant Mature Ovarian Cystic Teratoma in a Pediatric Patient: Case Report and Literature Review.

Mature cystic teratomas, also called dermoid cysts, are the most common germ-cell ovarian neoplasms in children. On average, ovarian dermoid cysts are slow-growing neoplasms with a mean size between 6.4 and 7.0 cm that enlarge at a rate of 1.8 mm/year; however, these can reach large dimensions. Giant ovarian tumors are defined as those having a maximum diameter equal to or more than 15 cm; these represent a therapeutic challenge as they increase the risk of wide wound size and surgical invasiveness. In this paper, we present a case of a 10-year-old Hispanic female that complained of abdominal pain, distension, and nausea. Physical examination revealed a mass on the left side of the abdomen and an axial computed tomography found a large pelvic tumor extending to the abdominal region. After a laparotomy approach, pathology evaluation confirmed the diagnosis of mature cystic teratoma. The patient recovered thoroughly and had no complications at a 6-month follow-up. We conducted a literature review including English and Spanish reports about giant ovarian teratomas; we retrieved 16 cases from 2003 to 2023. We concluded that giant ovarian tumors may be underreported, particularly in resource-limited areas where tumors might grow unrecognized, and that English-language bias might play a substantial role in literature reviews involving case reports and case series.

A Complete Workflow for High Throughput Human Single Skeletal Muscle Fiber Proteomics.

Skeletal muscle is a major regulatory tissue of whole-body metabolism and is composed of a diverse mixture of cell (fiber) types. Aging and several diseases differentially affect the various fiber types, and therefore, investigating the changes in the proteome in a fiber-type specific manner is essential. Recent breakthroughs in isolated single muscle fiber proteomics have started to reveal heterogeneity among fibers. However, existing procedures are slow and laborious, requiring 2 h of mass spectrometry time per single muscle fiber; 50 fibers would take approximately 4 days to analyze. Thus, to capture the high variability in fibers both within and between individuals requires advancements in high throughput single muscle fiber proteomics. Here we use a single cell proteomics method to enable quantification of single muscle fiber proteomes in 15 min total instrument time. As proof of concept, we present data from 53 isolated skeletal muscle fibers obtained from two healthy individuals analyzed in 13.25 h. Adapting single cell data analysis techniques to integrate the data, we can reliably separate type 1 and 2A fibers. Ninety-four proteins were statistically different between clusters indicating alteration of proteins involved in fatty acid oxidation, oxidative phosphorylation, and muscle structure and contractile function. Our results indicate that this method is significantly faster than prior single fiber methods in both data collection and sample preparation while maintaining sufficient proteome depth. We anticipate this assay will enable future studies of single muscle fibers across hundreds of individuals, which has not been possible previously due to limitations in throughput.

Análisis bibliométrico de la producción científica del Dr. Antonio Vidal Mayorga (1895-1968), Revista Médica Hondureña / Bibliometric analysis of the scientific production of Dr. Antonio Vidal Mayorga (1895-1968), Revista Médica Hondureña

Antecedentes: El Instituto de Enfermedades Infecciosas y Parasitología Antonio Vidal conmemora el trigésimo aniversario de su creación (1993-2023). Objetivo: Realizar un análisis bibliométrico de la producción científica del Dr. Antonio Vidal Mayorga en la Revista Médica Hondureña (RMH). Métodos: Análisis bibliométrico y revisión de alcance mediante búsquedas digitales en la Biblioteca Virtual en Salud de Honduras (https:// honduras.bvsalud.org/) y la RMH (https://revistamedicahondurena. hn/), y archivos físicos del Instituto Antonio Vidal. Los artículos fueron clasificados por tipo, año de publicación, tema específico (enfermedades transmisibles, agentes etiológicos y vectoriales, enfermedades crónicas no transmisibles, otros) y tema general (especialidades médicas, enfermedades, reseñas biográficas, actividades asistenciales y de salud pública, otros). Resultados: En los primeros 18 años de la RMH (1930-1947), el Dr. Vidal publicó 79 artículos: caso clínico 19, opinión 18, original 17, revisiones bibliográficas 11, reseñas de revistas 7 y libros 2, editoriales 5. Los años con mayor número de publicaciones fueron 1934 (10) y 1945 (16). Los temas generales con el mayor número de publicaciones fueron malaria (22) y deficiencias nutricionales (9). Se destacan sus observaciones originales con caracterizaciones clínicas, resultados de laboratorio y observaciones epidemiológicas en el campo, incluyendo observaciones entomológicas, y los artículos de opinión con propuestas sobre la organización y administración de la salud pública del país. Discusión: El Dr. Antonio Vidal Mayorga, médico y maestro ejemplar, se distingue en el contexto de la época en que vivió. Su obra fue impulsada por su capacidad de conjuntar la clínica, la epidemiología, el laboratorio, la salud pública, la investigación, la docencia y la proyección social...(AU)

Complete Workflow for High Throughput Human Single Skeletal Muscle Fiber Proteomics.

Skeletal muscle is a major regulatory tissue of whole-body metabolism and is composed of a diverse mixture of cell (fiber) types. Aging and several diseases differentially affect the various fiber types, and therefore, investigating the changes in the proteome in a fiber-type specific manner is essential. Recent breakthroughs in isolated single muscle fiber proteomics have started to reveal heterogeneity among fibers. However, existing procedures are slow and laborious requiring two hours of mass spectrometry time per single muscle fiber; 50 fibers would take approximately four days to analyze. Thus, to capture the high variability in fibers both within and between individuals requires advancements in high throughput single muscle fiber proteomics. Here we use a single cell proteomics method to enable quantification of single muscle fiber proteomes in 15 minutes total instrument time. As proof of concept, we present data from 53 isolated skeletal muscle fibers obtained from two healthy individuals analyzed in 13.25 hours. Adapting single cell data analysis techniques to integrate the data, we can reliably separate type 1 and 2A fibers. Sixty-five proteins were statistically different between clusters indicating alteration of proteins involved in fatty acid oxidation, muscle structure and regulation. Our results indicate that this method is significantly faster than prior single fiber methods in both data collection and sample preparation while maintaining sufficient proteome depth. We anticipate this assay will enable future studies of single muscle fibers across hundreds of individuals, which has not been possible previously due to limitations in throughput.

Use of the diadochokinetic index DDKCCVP% in the detection of articulatory inaccuracies in Parkinson's disease: a preliminary exploratory study / Utilidad del índice diadococinético DDKCVP% para la detección de imprecisiones articulatorias en enfermedad de Parkinson: estudio exploratorio preliminar

ABSTRACT Purpose: to explore whether the diadochokinetic index of syllable production variability (DDKcvp%) is useful for the detection of articulatory inaccuracies in different stages of Parkinson's disease (PD). Methods: a diadochokinetic speech task of the consonant-vowel type [pa-pa-pa] was applied to 18 people with PD (classified in stages of progression from 1 to 5 according to the Hoehn & Yahr scale) to determine their diadochokinetic performance. Records of the study group were compared to a reference value obtained from a control group made up of 40 subjects. Results: 77.78% of the study group showed articulatory inaccuracies. The DDKcvp% index allowed to detect articulatory difficulties from stage 1 of PD, and its variation showed that articulatory deficits were permanent from stage 2 onwards. A significant and direct correlation was obtained between the increase in the DDKcvp% index and the increase in the stage of evolution of the participants. Conclusion: DDKcvp% index evaluated by means of a simple and fast consonant-vowel diadochokinetic task [pa-pa-pa], could be useful to determine articulatory inaccuracies in different stages of PD, although it is suggested that investigation of this index in larger sample sizes be conducted.

RESUMEN Objetivo: explorar si el índice diadococinético de variabilidad de la producción silábica (DDKcvp%) es útil para la detección de imprecisiones articulatorias en distintos estadios de la Enfermedad de Parkinson (EP). Métodos: se aplicó una tarea diadococinética de habla del tipo consonante-vocal [pa-pa-pa] a 18 personas con EP (clasificadas en estadios de evolución del 1 al 5 según la escala Hoehn & Yahr) para determinar su rendimiento diadococinético. Los registros del grupo de estudio fueron comparados con un valor de referencia obtenido de un grupo control compuesto por 40 personas. Resultados: el 77,78% del grupo de estudio evidenció imprecisiones articulatorias. Además, el índice DDKcvp% permitió pesquisar dificultades articulatorias desde el estadio 1 de la EP, y su variación evidenció que los déficits articulatorios son permanentes desde el estadio 2 en adelante. También, se obtuvo una correlación significativa y directa entre el aumento del índice DDKcvp% con el incremento del estadio de evolución en el que se encontraban los participantes. Conclusión: el índice DDKcvp%, evaluado mediante una tarea diadococinética simple y rápida tipo consonante-vocal [pa-pa-pa], podría presentar una correcta utilidad para determinar imprecisiones articulatorias en distintos estadios de la EP, aunque se sugiere continuar investigando este índice en tamaños muestrales más amplios.

Perfil epidemiológico y parasitosis intestinales en tres comunidades atendidas por organización no gubernamental, Tegucigalpa, Honduras / Epidemiologic profile and intestinal parasitism in three communities served by non-governmental organization, Tegucigalpa, Honduras

Antecedentes: Alternativas y Oportunidades (AyO), Organización No Gubernamental (ONG) sin fines de lucro ha ofrecido programas educativos durante 32 años en mercados capitalinos y comunidades de escasos recursos de Tegucigalpa y Comayagüela. Objetivos: Determinar las características epidemiológicas y la frecuencia de parásitos intestinales de la población en tres sitios beneficiarios de AyO. Participantes y Métodos: Estudio descriptivo transversal de mayo a octubre 2019. Previo consentimiento/ asentimiento informados, se obtuvo datos sociodemográficos y epidemiológicos por encuesta en voluntarios de 0-49 años que proveyeron una muestra fresca de heces, examinada en el laboratorio por métodos directo, Kato-Katz, Baermann, coloración ácido resistente modificada y prueba inmunoantigénica ELISA. Resultados: Se encontró que en total 147 participantes era pobre, tenía trabajo informal mal remunerado, casas de adobe, madera, bloque o ladrillo; 92.5% (136) tenía letrina o inodoro, 97.2% (142) quemaba la basura o era recogida por camiones y 72.6% (106) compraba agua. La frecuencia de parásitos intestinales fue 3.4% (5) infección por helmintos, 62.5% (92) infecciones por protozoos comensales y dos especies patógenas: Giardia duodenalis 15.0% (22) y Cyclospora cayetanensis 2.0% (3). Blastocystis spp. 52.3% (77) y protozoos comensales Endolimax nana 36.7% (54), Entamoeba coli 32.6% (48) y Entamoeba hartmanni 23.2% (34), fueron los más frecuentes; 6.1% (9), tenía quistes de Entamoeba histolytica/E. dispar. La prueba inmunoenzimática de ELISA detectó 16.1% (19/118) infecciones por Giardia y ninguna infección por Cryptosporidium. Discusión: Promoción en higiene (WASH) y uso de filtros para agua de consumo es información importante que AyO debe promover al educar comunidades en salud...(AU)

Single muscle fibre contractile function with ageing.

Ageing is accompanied by decrements in the size and function of skeletal muscle that compromise independence and quality of life in older adults. Developing therapeutic strategies to ameliorate these changes is critical but requires an in-depth mechanistic understanding of the underlying physiology. Over the past 25 years, studies on the contractile mechanics of isolated human muscle fibres have been instrumental in facilitating our understanding of the cellular mechanisms contributing to age-related skeletal muscle dysfunction. The purpose of this review is to characterize the changes that occur in single muscle fibre size and contractile function with ageing and identify key areas for future research. Surprisingly, most studies observe that the size and contractile function of fibres expressing slow myosin heavy chain (MHC) I are well-preserved with ageing. In contrast, there are profound age-related decrements in the size and contractile function of the fibres expressing the MHC II isoforms. Notably, lifelong aerobic exercise training is unable to prevent most of the decrements in fast fibre contractile function, which have been implicated as a primary mechanism for the age-related loss in whole-muscle power output. These findings reveal a critical need to investigate the effectiveness of other nutritional, pharmaceutical or exercise strategies, such as lifelong resistance training, to preserve fast fibre size and function with ageing. Moreover, integrating single fibre contractile mechanics with the molecular profile and other parameters important to contractile function (e.g. phosphorylation of regulatory proteins, innervation status, mitochondrial function, fibre economy) is necessary to comprehensively understand the ageing skeletal muscle phenotype.

Challenges for International Medical Graduates in the US Graduate Medical Education and Health Care System Environment: A Narrative Review.

International medical graduates (IMGs) have become a vital part of the US graduate medical education (GME) and health care system (HCS) workforce; they contribute to essential diversity that relieves cultural and linguistic barriers to health care. The number of IMGs looking for medical training in the United States. has constantly been increasing in the last decades. The challenges they meet begin long before residency application, continue during their transition to residency programs, through early medical training, and eventually subside in senior years. IMGs' hurdles permeate the themes of navigating the US GME and HCS, adaptation to the US culture, communication skills, racial discrimination, emotional distress, and finances. This article aims to comprehensively review available information concerning the challenges encountered by IMGs in their transition to the US GME and HCS environments.

Pharmacological inhibition of PRMT7 links arginine monomethylation to the cellular stress response.

Protein arginine methyltransferases (PRMTs) regulate diverse biological processes and are increasingly being recognized for their potential as drug targets. Here we report the discovery of a potent, selective, and cell-active chemical probe for PRMT7. SGC3027 is a cell permeable prodrug, which in cells is converted to SGC8158, a potent, SAM-competitive PRMT7 inhibitor. Inhibition or knockout of cellular PRMT7 results in drastically reduced levels of arginine monomethylated HSP70 family stress-associated proteins. Structural and biochemical analyses reveal that PRMT7-driven in vitro methylation of HSP70 at R469 requires an ATP-bound, open conformation of HSP70. In cells, SGC3027 inhibits methylation of both constitutive and inducible forms of HSP70, and leads to decreased tolerance for perturbations of proteostasis including heat shock and proteasome inhibitors. These results demonstrate a role for PRMT7 and arginine methylation in stress response.

Author Correction: Pharmacological inhibition of PRMT7 links arginine monomethylation to the cellular stress response.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Neumotórax espontáneo en embarazada: Reporte de un caso tratado por videotoracoscopia y revisión de la literatura / Spontaneous pneumothorax during pregnancy: case report of a patient treated with videothoracoscopy and literature review

RESUMEN El neumotórax espontáneo primario es la presencia de aire en la cavidad pleural como consecuencia de la ruptura de bulas o blebs subpleurales en un pulmón que por otro lado está sano y sin antecedentes traumáticos. Es más frecuente en hombres que en mujeres y es raro en el embarazo, habiéndose publicado menos de 60 casos en la literatura. El objetivo es reportar un neumotórax espontáneo en una embarazada y realizar una revisión del tema. El caso corresponde a una mujer de 19 años, primigestante que presenta un neumotórax espontáneo primario tratado inicialmente con pleurotomía, el cual evoluciona satisfactoriamente, pero a las 24 horas ser retirada esta, presenta recidiva por lo que se realiza videotoracoscopia con resección de bulas y pleurodesis. Evoluciona adecuadamente, se da de alta en buenas condiciones y posteriormente lleva a cabo su trabajo de parto vaginal sin complicaciones. El tratamiento del neumotórax en el embarazo es igual al de los pacientes no obstétricos. Los neumotórax espontáneos recurrentes, los persistentes, los con fuga aérea por el tubo más allá del cuarto día y los bilaterales son indicaciones de procedimiento quirúrgico por toracotomía o videotoracoscopia. Se debe considerar el diagnóstico en cualquier embarazada con dolor torácico agudo, disnea súbita o antecedentes de neumotórax previo y este debe ser confirmado con radiografía de tórax con la adecuada protección del feto. Su reconocimiento y manejo es esencial para evitar complicaciones a la madre y al feto. El tratamiento quirúrgico por videotoracoscopia fue seguro en este caso. MÉD.UIS. 2016;29(3):101-5.

ABSTRACT Primary spontaneous pneumothorax is the presence of air in the pleural cavity as a consequence of a rupture of bullae or subpleural blebs in an otherwise healthy lung, without a clear history of trauma. Is more frequent in men than in women, and rarely presents during pregnancy, less than 60 cases has been reported in literature. The objective is to report the case of a 19-year-old primiparous woman who presents spontaneous pneumothorax treated initially with pleurostomy. Initial evolution is satisfactory, but 24 hours after withdrawal of chest tube, patient recurs. Patient is managed with videothoracoscopic bullectomy followed by pleurodesis. The procedure was well tolerated and is discharged in optimum condition and subsequently goes into labor, giving birth without any complications. In conclusion, treatment of spontaneous pneumothorax during pregnancy can be safely managed in the same way as non-obstetric patients. Recurring, persistent, or with air leak beyond 4 days and bilateral spontaneous pneumothorax, are indication for thoracic surgery. The diagnosis of spontaneous pneumothorax must be considered in any pregnant woman with acute thoracic pain, sudden onset dyspnoea and past medical history of it. The diagnosis must be confirmed with chest X ray, considering fetus protecting measures. Recognition and opportune treatment of spontaneous pneumothorax in the pregnant woman is essential to avoid maternal or fetal complications. Videothoracoscopic treatment has been proven safe in this case. MÉD.UIS. 2016;29(3):101-5.

Asociación entre el patrón postural cefálico y la inteligibilidad articulatoria del habla / Relationship between postural cephalic pattern and speech intelligibility

RESUMEN Objetivo: el propósito de este estudio fue establecer un factor asociativo que relacione la morfología del sistema cráneo - cervical con el nivel de inteligibilidad articulatoria del habla en sujetos jóvenes. Métodos: estudio transversal, consideró una muestra de 42 jóvenes universitarios de un universo de 140, ambos sexos, sin antecedentes mórbidos y con un rango de edad entre 18 y 21 años. Se evalúo: a) inteligibilidad articulatoria mediante el coeficiente de variación periódica diadococinética, b) parámetros posturales estáticos tradicionales mediante método fotogramétrico y c) patrón postural cefálico mediante radiografía cefalométrica lateral. Resultados: se encontraron 36 sujetos con inteligibilidad adecuada y 6 alterada, donde la variable rotación cráneo cervical antero-posterior presentó diferencias estadísticamente significativas (p= 0,009) entre el grupo con inteligibilidad normal respecto al grupo con inteligibilidad alterada. El análisis de regresión lineal evidenció que sujetos que presentan rotación posterior de cabeza sobre cuello presentan mayor variabilidad en la emisión silábica del rendimiento diadocinético del habla (Sq r lineal = 0,128). Conclusión: se establece que la postura cefálica con presencia de rotación posterior de la cabeza sobre el cuello se asocia a la pérdida de inteligibilidad del habla en la muestra estudiada.

ABSTRACT Purpose: the objective of this study was to establish an associative factor that connects the morphology of the craniocervical system with the articulatory speech intelligibility level in young subjects. Methods: a cross-sectional study which considered a sample of 42 university students from a universe of 140, both male and female, without morbid background ranging between 18 and 21 years of age. Evaluated aspects: a) articulatory intelligibility by the diadochokinetic periodic variation coefficient, b) traditional static postural parameters using the photogrammetric method, and c) cephalic postural pattern by lateral cephalometry (X-ray) Results: 36 subjects with adequate intelligibility and 6 with altered intelligibility where the anteroposterior cranio-cervical rotation variable showed significant differences (p = 0.009) between the group with normal intelligibility and the group with impaired intelligibility. The linear regression analysis demonstrated that subjects with posterior head-neck rotation exhibited more variability in the syllable emission of diadochokinetic speech performance (Sq r linear = 0.128). Conclusion: it is established that the cephalic position with subsequent posterior head-neck rotation is associated with the loss of speech intelligibility in the studied sample.

Efecto del nivel proteico de la dieta sobre el desarrollo de juveniles de Macrobrachium tenellum (Smith, 1871) / Effect of dietary protein level on the development of juveniles of Macrobrachium tenellum (Smith, 1871)

Objetivo.Evaluar el efecto de cinco niveles de proteína cruda (PC) en alimentos balanceados sobre el crecimiento, sobrevivencia y tasa de conversión alimenticia (FCA) en juveniles de Macrobrachium tenellum. Materiales y métodos. Se alimentó por 60 días a juveniles de M. tenellum (0.31±0.01 g y 32.62±1.10 mm) con niveles de 20, 25, 30, 35 y 40% de PC en el alimento. Los organismos fueron distribuidos al azar en 15 tinas experimentales de 64 L (15 org./tina) bajo condiciones controladas (5.95±0.41 ppm de oxígeno, 29.89±0.72°C, y pH 8.44±0.15) y alimentados con el 10% de su peso vivo. Resultados. El porcentaje de sobrevivencia fue del 98.22±3.96% sin diferencias significativas entre los tratamientos (p>0.05). Los organismos alimentados con un 40% de PC tuvieron un peso significativamente mayor (p<0.05) respecto a los demás tratamientos (cambio de peso de 0.54±0.02g; incremento de peso de 173.60±12.99%; y tasa de crecimiento específico de 1.68±0.08). El FCA fue significativamente mejor (p<0.05) en los organismos alimentados con 35 y 40% de PC (2.85±0.18 y 2.40±0.05, respectivamente) que los demás tratamientos. Conclusiones. Los organismos juveniles de M. tenellum alimentados con niveles altos de proteína (40%), se desarrollaron más rápido que organismos que recibieron una menor concentración de proteína bajo las condiciones experimentales establecidas en este estudio.

Objective. To evaluate the effect of five levels of crude protein (CP) in balanced feed on the survival, growth and feed conversion ratio (FCA) in juveniles of Macrobrachium tenellum. Materials and methods. Juveniles of M. tenellum (0.31±0.01g and 32.62±1.10mm) were fed for 60 days with 20, 25, 30, 35 and 40% of CP in feed. The organisms were randomly distributed in 15 experimental tanks (15 org /tank) under controlled conditions (5.95±0.41 ppm of oxygen, 29.89 ± 0.72 °C, and pH 8.44±0.15) and fed with 10% of its live weight. Results. The survival percentage was 98.22±3.96% with no statistical difference between treatments (p>0.05). The organisms fed with 40% CP in their diet had a significantly higher weight (p<0.05) compared to the other treatments (weight change of 0.54±0.02g; weight increase 173.60±12.99%, and specific growth rate of 1.68±0.08). The FCA was significantly better (p<0.05) in organisms fed with 35 and 40% CP (2.85±0.18 and 2.40±0.05, respectively) than other treatments. Conclusions. Juveniles of M. tenellum fed with high protein levels (40%) developed faster than organisms which received a lower concentration of the protein under the experimental conditions established for this study.