The Vertebrobasilar Trunk and Its Anatomical Variants: A Microsurgical Anatomical Study.

BACKGROUND: The trunk of the basilar artery has not been included in microanatomy studies. Anatomical variants of the perforant branches of the vertebrobasilar trunk and their relationship with neural structures are very important in surgical approaches. Surgical dissection for the treatment of vascular lesions requires a perfect knowledge of the microsurgical anatomy. METHODS: We conducted a descriptive analysis of 50 brains, which were fixed with formalin at 10% for 2 weeks, and the arterial system was injected with colored latex. After microsurgical dissection, it was divided into three segments: the lower portion went from the anterior spinal artery to the anteroinferior cerebellar artery, the middle segment was raised from the upper limit of the lower portion to the origin of the superior cerebellar artery, and the upper segment ranged from the previous portion until the origin of the posterior cerebral artery. RESULTS: The basilar artery had an average length of 30 mm. The average diameter at its junction with the vertebral arteries was 4.05 mm. The average middle segment was 3.4 mm in diameter and 15.2 mm in length. The diameter of the upper segment was 4.2 mm, and its average length was 3.6 mm. The average number of bulbar arteries was three, and their average diameter was 0. 66 mm. The number of caudal perforator arteries were five on average, with a diameter of 0.32 mm. We found three rare cases of anatomical variants in the vertebra-basilar junction. CONCLUSIONS: The basilar artery emits penetrating branches in its lower, middle, and upper portions. The origin of penetrating branches was single or divided after forming a trunk. However, we observed long branches from perforant arteries.

Latex vascular injection as method for enhanced neurosurgical training and skills.

Background: Tridimensional medical knowledge of human anatomy is a key step in the undergraduate and postgraduate medical education, especially in surgical fields. Training simulation before real surgical procedures is necessary to develop clinical competences and to minimize surgical complications. Methods: Latex injection of vascular system in brain and in head-neck segment is made after washing out of the vascular system and fixation of the specimen before and after latex injection. Results: Using this latex injection technique, the vascular system of 90% of brains and 80% of head-neck segments are well-perfused. Latex-injected vessels maintain real appearance compared to silicone, and more flexible vessels compared to resins. Besides, latex makes possible a better perfusion of small vessels. Conclusions: Latex vascular injection technique of the brain and head-neck segment is a simulation model for neurosurgical training based on real experiencing to improve surgical skills and surgical results.

Violencia urbana, "limpieza social" y conflicto armado en Caldas, 1980-2006

Se abordan las formas de violencia que afectan los contextos urbanos, conocidas como "limpieza social", en el departamento de Caldas entre 1980 y 2006. Estas se analizarán junto con el crecimiento de los grupos armados ilegales, con especial énfasis en el paramilitarismo. El objetivo es evidenciar las estrategias discursivas que se aplican por parte de sectores poderosos para estigmatizar ciertas prácticas y actores sociales, principalmente a través de los medios de comunicación. Se apeló al Análisis Crítico del Discurso, aplicado a los enunciados referentes al fenómeno en cuestión, y se siguieron las tesis de Foucault en lo referente a los dispositivos de normalización y la discriminación entre lo normal y lo anormal en la dinámica de las relaciones de poder También se asume la perspectiva moral que se halla en la base de la "limpieza social" y se postulan las razones de su persistencia. Los resultados muestran un proceso que va de la dispersión a la sistematicidad en relación con el exterminio social y sus manifestaciones discursivas. Las conclusiones dan cuenta de la persistencia del fenómeno en contextos contemporáneos.

The forms of violence that affect urban contexts, generally known as "social cleansing", are addressed in the department of Caldas between 1980 and 2006. These will be analyzed along with the growth of the illegal armed groups, with special emphasis on paramilitarism. The objective is to highlight the discursive strategies that are applied by powerful groups to stigmatize certain practices and social actors, mainly through the media. Critical discourse analysis was used, applied to the statements referring the mentioned phenomenon, and Foucault's thesis regarding normalization devices and discrimination between normal and abnormal in the dynamics of power relations were followed. The moral perspective that is at the base of "social cleansing" is also assumed and the reasons for its persistence are postulated. The results show a process that goes from dispersion to systematicity in relation to social extermination and its discursive manifestations. The conclusions show the persistence of the phenomenon in contemporary contexts.

São abordadas as formas de violência que afetam os contextos urbanos, conhecidas como "limpeza social", no departamento de Caldas entre 1980 e 2006. Elas serão analisadas juntamente com o crescimento de grupos armados ilegais, com ênfase especial no paramilitarismo. O objetivo é destacar as estratégias discursivas aplicadas por setores poderosos para estigmatizar determinadas práticas e atores sociais, principalmente por meio da mídia. A Análise Crítica do Discurso foi aplicada às declarações referentes ao fenômeno em questão, e a tese de Foucault foi seguida em relação aos dispositivos de normalização e à discriminação entre o normal e o anormal na dinâmica das relações de poder. Ela também assume a perspectiva moral que está na base da "limpeza social" e postula as razões de sua persistência. Os resultados mostram um proceso que vai da dispersão à sistematicidade em relação ao extermínio social e suas manifestações discursivas. As conclusões mostram a persistência do fenômeno em contextos contemporâneos.

Dilemas bioéticos en el desempeño del médico de la familia en la pesquisa del cáncer colorrectal

Introducción: La calidad del desempeño profesional determina la resolución de problemas de salud pública como el cáncer colorrectal a través de su pesquisa poblacional, en cuya realización, como en toda práctica médica, surgen dilemas bioéticos. Objetivo: Caracterizar los principales dilemas bioéticos en la realización de la pesquisa poblacional del cáncer colorrectal en la atención primaria. Materiales y métodos: Estudio descriptivo transversal en 19 médicos de la familia, seleccionados por muestreo simple aleatorio mediante la aplicación de un cuestionario en proceso de validación a través de criterio de expertos y coeficiente alfa de Cronbach. La variable estudiada fue "dilemas bioéticos en la realización de la pesquisa poblacional del cáncer colorrectal", parametrizada en dos dimensiones: valorativa y cognitiva, con cinco y tres indicadores respectivamente. Resultados: El "dilema por temor a realizarse la colonoscopia" fue considerado el de mayor peso, al ser evaluado por 13 médicos (68,4 %) como Muy Importante. El indicador "conocimiento profesional sobre bioética" fue evaluado por la mayoría de los profesionales dentro de los dos niveles superiores de la escala de Likert: cinco médicos (26,3 %) eligieron la categoría Importante, e igual número la de Muy Importante. Conclusiones: Los principales dilemas bioéticos a que se enfrentan los médicos de la familia en su desempeño profesional durante la realización de la pesquisa poblacional del cáncer colorrectal, están caracterizados por las actitudes que asumen los pacientes en relación con la disyuntiva que presupone la realización de la colonoscopia, con sus potenciales riesgos ante un resultado positivo.

Introduction: The quality of professional performance determines the resolution of public health problems such as colorectal cancer through population screening, in whose implementation, as in every medical practice, bioethical dilemmas arise. Objective: To characterize the main bioethical dilemma in carrying out population screening for colorectal cancer in primary care. Materials and methods: Cross-sectional, descriptive study in 19 family physicians, selected by simple random sampling, by application of a questionnaire in the process of validation through expert criteria and Cronbach alpha coefficient. The variable studied was "bioethical dilemmas in carrying out population screening for colorectal cancer" parameterized in two dimensions: evaluative and cognitive, with 5 and 3 indicators respectively. Results: The "dilemma for fear of having a colonoscopy" was considered the most important, being evaluated by 13 doctors/68.4% as Very Important; The indicator "professional knowledge about bioethics" was evaluated by the majority of professionals within the two upper levels of the Likert scale, 5 doctors (26.3%) chose the category of Important and an equal number the category of Very Important. Conclusions: The main bioethical dilemmas that family doctors face in their professional performance during population screening for colorectal cancer are characterized by the attitudes that patients assume in relation to the dilemma that presupposes performing colonoscopy with its potential risks to a positive result.

Seno cavernoso: anatomía, histología y terminología.

BACKGROUND: Although the cavernous sinus (CS) has been studied since 1695, its anatomy and name are still under discussion. METHOD: Anatomy and histology of 40 CS from human cadavers were studied, included both from a newborn specimen. RESULTS: Two walls limit the CS, an inferior medial one composed only of the dura's outer layer and a superior lateral one consisting of both dura's layers. Sinusoidal veins pass through the lateral wall of the CS as a transition between venous tributaries and the CS. An endothelial layer covers the inner surface of the CS and the outer surface of the internal carotid artery. The space within the CS shows trabeculae, which are rarer in adults compared to the newborn. The loss of trabeculae in the CS may be a natural process along with life. CONCLUSIONS: In conclusion, the CS is a real sinus, and the term "cavernous sinus" is appropriately applied.

ANTECEDENTES: Si bien el seno cavernoso (SC) ha sido estudiado desde 1695, su anatomía y nombre aún están bajo discusión. MÉTODOS: Se estudiaron la anatomía y la histología de 40 SC de cadáveres humanos, incluyendo los dos de un recién nacido. RESULTADOS: El SC está limitado por dos paredes, una inferomedial compuesta solo por la capa más externa de la duramadre y otra superolateral compuesta por ambas capas de la duramadre. Hay venas sinusoidales que atraviesan la pared lateral del SC formando una transición entre venas tributarias y el SC. Una capa endotelial recubre la superficie interna del SC y la superficie externa de la arteria carótida interna. El espacio dentro del SC presenta trabéculas, las cuales son escasas en el adulto en comparación con el recién nacido. La pérdida de trabéculas en el SC puede ser un proceso natural a lo largo de la vida. CONCLUSIONES: En conclusión, el SC es un verdadero seno, por lo que el término «seno cavernoso¼ se aplica de forma correcta.

Terapia antiviral de acción directa para infección del virus de hepatitis C en pacientes en hemodiálisis

Introducción: La infección por el virus C de la hepatitis resulta común en pacientes en hemodiálisis y se considera endémica en estas unidades. El tratamiento utilizado lo componían el interferón pegilado y la ribavirina, combinación que presentaba niveles de toxicidad y baja respuesta. Las drogas actuales aportan mejores resultados. Objetivos: Determinar la eficacia y seguridad de la terapia antiviral de acción directa para la infección del virus de la hepatitis C en pacientes con insuficiencia renal crónica en hemodiálisis. Métodos: Estudio descriptivo prospectivo en 19 pacientes en régimen de hemodiálisis y con infección por virus C, pertenecientes al Hospital General Docente "Dr. Mario Muñoz Monroy", desde diciembre de 2020 hasta septiembre de 2021," A todos se les prescribió durante 12 semanas Sofosbuvir® 400 mg más Daclatasvir® 60 mg diarios. Se caracterizaron las variables edad, sexo, fibrosis hepática por el índice aspartato-aminotransferasa/plaquetas, reacciones adversas y respuesta viral 12 semanas después del tratamiento. Resultados: La infección predominó en el grupo de 51 a 60 años (36,84 %). La mayoría de los pacientes mostró un índice aspartato-aminotransferasa/plaquetas ≤ 0,5, lo que correspondió con ausencia de fibrosis hepática significativa (14 pacientes). Una minoría de pacientes registró reacciones adversas. No se demostró toxicidad cardiovascular ni hepática. La totalidad de los pacientes manifestaron carga viral no detectable 12 semanas después del tratamiento. Conclusiones: La combinación de Sofosbuvir® con Daclatasvir® para el tratamiento de la infección por virus de la hepatitis C en pacientes con insuficiencia renal crónica en tratamiento de hemodiálisis resultó eficaz, bien tolerada y segura.

Introduction: Hepatitis C virus infection is common in hemodialysis patients and is considered endemic in these units. The treatment used consisted of pegylated interferon and ribavirin, a combination that presented levels of toxicity and low response. Current drugs bring better results. Objectives: To determine the efficacy and safety of direct-acting antiviral therapy for hepatitis C virus infection in patients with chronic renal failure on hemodialysis. Methods: Prospective descriptive study in 19 patients on hemodialysis and with virus C infection, belonging to "Dr. Mario Muñoz Monroy" Teaching General Hospital, from December 2020 to September 2021. All were prescribed for 12 weeks with Sofosbuvir® 400 mg plus Daclatasvir® 60 mg daily. The variables age, sex, liver fibrosis were characterized by the aspartate aminotransferase/platelet index, adverse reactions and viral response 12 weeks after treatment. Results: Infection predominated in the group of 51 to 60 years (36.84%). Most patients showed an aspartate aminotransferase/platelet ratio ≤ 0.5, corresponding to the absence of significant liver fibrosis (14 patients). A minority of patients reported adverse reactions. No cardiovascular or hepatic toxicity was demonstrated. All patients had an undetectable viral load 12 weeks after treatment. Conclusions: The combination of Sofosbuvir® with Daclatasvir® for the treatment of hepatitis C virus infection in patients with chronic renal failure undergoing hemodialysis was effective, well tolerated and safe.

Photocatalytic Activity and Self-Cleaning Effect of Coating Mortars with TiO2 Added: Practical Cases in Warm Sub-Humid Climates.

In this study, the photocatalytic activity of coating mortars with synthetized and commercial TiO2 nanoparticles added has been evaluated at 2, 3 and 5% by weight of cement by calculating the degradation efficiency of methyl orange and red wine dyes exposed to both visible-light and UV radiation; also, the self-cleaning effect of coatings exposed to weather conditions (warm sub-humid climate) was assessed. TiO2 nanoparticles were synthesized via the sol-gel method to a low synthesis temperature and characterized via X-ray diffraction (XRD) and Scanning Electron Microscopy (SEM). The results show synthesized TiO2 particles in anatase phase with a crystallite size of 14.69 nm, and hemispherical particles with sizes of submicron order. The addition percentage with the best performance in the coating mortars was 3%, with both commercial and synthesized TiO2; however, coating mortars with synthesized TiO2 exhibited the highest degradation efficiency for both dyes when they were exposed to visible light, while mortars with commercial TiO2 exhibited the highest degradation efficiency when exposed to UV radiation. In addition, in coating mortars with synthesized TiO2, the self-cleaning effect was evident from the beginning of exposure to weather, reaching the largest dye-free surface at the end of exposure. The compressive strength increased significantly in mortars with TiO2 addition.

Mortalidad por diabetes mellitus en el municipio de Colón, Matanzas. 2011-2021 / Mortality due to diabetes mellitus in the municipality of Colon, province of Matanzas. 2011-2021

RESUMEN Introducción: la diabetes mellitus, considerada uno de los principales problemas de salud a nivel mundial, es de las enfermedades que más caras resultan a la sociedad, debido a su alta y temprana mortalidad. Objetivos: caracterizar el comportamiento de la mortalidad causada por la diabetes mellitus en el municipio de Colón, en los últimos once años. Materiales y métodos: estudio descriptivo retrospectivo de la base de datos de fallecidos de la Dirección Municipal de Salud del municipio de Colón, desde el 1 de enero de 2011 hasta el 31 de diciembre de 2021. Fueron seleccionados 221 sujetos con diabetes mellitus como causa básica de muerte. Las variables independientes fueron: año de fallecimiento, sexo, edad y causa directa de muerte. Los resultados se analizaron con estadística descriptiva, a través del paquete SPSS. Resultados: tendencia creciente de la mortalidad, más acentuada en el año 2021, en el que fallecieron 38 diabéticos. Predominio en mujeres (134) con respecto a hombres (87), y en el grupo etario de 65 años y más (67,4 %). Se identificaron como más frecuentes causas de muerte las enfermedades del corazón (24 %), la bronconeumonía (20,4 %) y la insuficiencia renal crónica (14,9 %). Conclusiones: en el municipio de Colón, la mortalidad por diabetes mellitus ha mostrado una tendencia al alza durante los últimos once años; el predominio en mujeres, personas mayores de 65 años, y las enfermedades del corazón como causas directas de muerte, caracterizaron su comportamiento.

ABSTRACT Introduction: diabetes mellitus, considered one of the main health problems worldwide, is among the diseases resulting more expensive to society, because of its high and early mortality. Objective: to characterize the behavior of mortality caused by diabetes mellitus in the municipality of Colon, in the last eleven years. Materials and methods: descriptive, retrospective study of the database of deaths from the Municipal Health Department of the municipality of Colon, from January 1st 2011 to December 31st, 2021. 221 subjects with diabetes mellitus with diabetes mellitus main cause of death were chosen. The independent variables were: year of death, gender, age and direct cause of death. The results were analyzed using descriptive statistics, through SPSS package. Results: increasing tendency of mortality, more accentuated in 2021, when 38 diabetic patients died. Women (134) predominated over men (87) and predominated also the age group of 65 years and over (67.4 %). Hearth diseases (24 %), bronchopneumonia (20.4 %), and chronic renal failure (14.9 %) were identified as more frequent causes of death. Conclusions: mortality due to diabetes mellitus has showed an increasing tendency during the last eleven years; the predominance in women, people over 65 years, and hearth diseases as direct causes of death characterized its behavior.

Long-term Mate Selection in Latin America: An Analysis of Personal Ads / Selección de Parejas a Largo Plazo en Latinoamérica: Un Análisis de Anuncios Personales

Abstract The present work aims to study which factors are relevant in long-term mate selection from a lonely-hearts personal advertisement sample of Spanish-speaking consumers of Cosmopolitan Magazine, Colombian Edition. We analyzed One thousand four hundred sixty-eight publications (made by 770 men and 698 women) using a coding system based on the theories of sexual strategies, genetic quality indicators, and the preferences classification used in personal ads studies. Initially, we found trends as a greater predilection for psychological attributes and a greater demand to require more traits than offering them. In addition, the cross-cultural pattern demonstrated that men prefer women's physical characteristics, while women require status/resources by men. Finally, men tended to be more selective in the age range of 36-45 years, while women's selectivity decreased with age. The results replicate many of the patterns found in investigations related to human sexual selection, also bring enlightenment about new preference dimensions to study in the future.

Resumen La presente investigación examina las preferencias de individuos que buscan emparejarse a largo plazo, por medio del análisis de anuncios de búsqueda de parejas, publicados por una muestra de usuarios hispanohablantes de la edición Colombiana de la Revista Cosmopolitan. Se revisaron 1468 publicaciones (de 770 hombres y 698 mujeres) utilizando un sistema de codificación construido a partir de la teoria de estrategias sexuales, indicadores de calidad genética y clasificaciones usadas en estudios de anuncios personales. Los usuarios reportaron una mayor atención por atributos psicológicos, además de una alta exigencia. Adicionalmente, los hombres solicitaron más características fisicas de las mujeres, y las mujeres más indicadores asociados al estatus y recursos de los hombres. Los hombres se mostraron más selectivos entre los 36 y los 45 anos, mientras que la selectividad de las mujeres disminuyó con la edad. Los resultados replican patrones encontrados en las investigaciones sobre emparejamiento sexual humano, y dan luces sobre nuevos dominios de preferencia para examinar en el futuro.

Causas de muerte en pacientes con cáncer colorrectal en el quinquenio 2016-2020. Colón, Matanzas

RESUMEN Introducción: el cáncer colorrectal constituye la tercera causa de muerte por tumores malignos en Cuba. Su estadio en el momento del diagnóstico es el predictor más importante de supervivencia, por lo que al analizar las causas de muerte se puede conocer la precocidad en su detección. Objetivo: determinar las principales causas de muerte de los pacientes fallecidos por cáncer colorrectal. Materiales y métodos: se realizó un estudio descriptivo retrospectivo de las causas de muerte en 149 pacientes con cáncer colorrectal como causa primaria de muerte en el municipio de Colón, entre el 1 de enero de 2016 y el 31 de diciembre de 2020, notificados en el Registro de Fallecidos de la Dirección Municipal de Salud. Las variables independientes utilizadas fueron: sexo, grupos etarios, edad, causa directa de muerte, causa de sepsis. Resultados: predominó el sexo femenino en los pacientes fallecidos por cáncer colorrectal (53 %). La mortalidad se incrementó a partir de los 60 años de edad (124 pacientes, para un 83,2 %). La causa directa de muerte predominante fue la toxemia cancerígena (61,1 %), seguida de la sepsis (28,1 %) y el tromboembolismo pulmonar (3,4 %). Conclusiones: las causas de muerte de los pacientes con cáncer colorrectal en el municipio Colón, en el quinquenio 2016-2020, fueron indicativas de enfermedad neoplásica en estadio avanzado y de diagnóstico tardío.

ABSTRACT Introduction: colorectal cancer is the third cause of death due to malignant cancer in Cuba. Its stage at the time of diagnosis is the most important predictor of survival, so when analyzing the causes of death it is possible to know the precocity in its detection. Objective: to determine the main causes of death in patients who died of colorectal cancer. Materials and methods: a retrospective descriptive study of the causes of death was carried out in 149 patients with colorectal cancer as the primary cause of death in the municipality of Colon, between January 1, 2016 and December 31, 2020, recorded in the Death Registry of the Municipal Health Directorate. The independent variables used were: gender, age groups, age, direct cause of death, cause of sepsis. Results: female sex predominated in patients who died due to colorectal cancer (53 %). Mortality increased after the age of 60 years (124 patients, for 83.2 %). The predominant direct cause of death was carcinogenic toxemia (61.1 %), followed by sepsis (28.1 %) and pulmonary thromboembolism (3.4 %). Conclusions: the causes of death of patients with colorectal cancer in the municipality of Colón in the five-year period 2016-2020 period were indicative of advanced stage neoplastic disease and late diagnosis.

Short term exposure to ambient air pollutants and cardiovascular emergency department visits in Mexico city.

Available data on the acute cardiovascular effect of ambient air pollution (AAP) in Latin America is limited considering that over 80% of its 1 billion inhabitants live in urban settlements with poor air quality. The study aim was to evaluate the association between Cardiovascular Emergency Department Visits (CEDVs) and AAP in Mexico City from 2016 to 2019 using generalized additive models with distributed lags to examine the percentage change of CEDVs and a backward approach of time-series model to calculate attributable fractions. A total of 48,891 CEDVs were recorded in a period of 1019 days. We estimated a significant percentage increase for each 10 µg/m3 of PM10 at Lag0-5 (2.8%, 95%CI 0.6-5.0), PM2.5 at Lag0-6 (3.7%, 95%CI 0.1-7.6), O3 at Lag0-5 (1.1%, 95%CI 0.2-2.0), NO2 at Lag0-4 (2.5%, 95%CI 0.3-4.7) and for each 1 mg/m3 of CO at Lag0 (6.6%, 95%CI 0.3-13.2). Overall, 10.3% of CEDVs in Mexico City may be related to PM10 exposure, 9.5% to PM2.5, 10.3% to O3, 11% to NO2 and 5.7% to CO. AAP significantly increase cardiovascular morbidity impacting on emergency medical services.

La risa contagiosa como estímulo incondicionado en condicionamiento clásico de actitudes hacia marcas comerciales / Contagious Laughter as an Unconditioned Stimulus in Classical Conditioning of Attitudes Towards Commercial Brands

Resumen La literatura sobre condicionamiento clásico de actitudes (CCA) no reporta utilización de vocalizaciones humanas para crear o intensificar actitudes. El propósito del estudio fue comprobar la capacidad de los estímulos acústicos de risa contagiosa para originar actitudes positivas hacia marcas comerciales neutras cuando estos se utilizan como estímulos incondicionados en CCA. Participaron 60 universitarios de ambos sexos con edades entre 18 y 30 años y con base en un diseño experimental intrasujeto se aplicó el CCA, que implicó apareamiento simultáneo de marcas comerciales neutras con risas más y menos contagiosas. Se verificaron 5 hipótesis que compararon actitudes explícitas (medidas con diferencial semántico) e implícitas (medidas mediante un priming evaluativo y amplitud electromiográfica —EMC— del músculo cigomático) entre el pre- y el poscondicionamiento y entre marcas condicionadas con risas más vs. menos contagiosas. .on respecto a línea de base, se observaron mayores actitudes explícitas poscondicionamiento hacia marcas comerciales apareadas con risas más contagiosas; no se encontraron diferencias actitudinales explícitas entre marcas condicionadas con risas más vs. menos contagiosas. Sólo se evidenciaron diferencias actitudinales implícitas entre el pre y el poscondicionamiento de la marca comercial apareada con risa masculina más contagiosa. No se observaron diferencias en la amplitud EMG del cigomático entre el pre y el poscondicionamiento ni entre marcas comerciales apareadas con risas más vs. menos contagiosas. Concluimos que la risa contagiosa tiene capacidad para transferir valencia afectiva a estímulos neutros y no siempre se observa concordancia entre las actitudes explícitas e implícitas poscondicionamiento.

Abstract The literature on classical conditioning of attitudes (CCA) does not report the use of human vocalizations to create or intensify attitudes. This study aimed to test the ability of contagious laughter acoustic stimuli to elicit positive attitudes towards neutral commercial brands when used as unconditioned stimuli in CCA. 60 university students of both genders, aged between 18 and 30 years, participated. Based on an intra-subject experimental design the CCA was applied, which involved the simultaneous pairing of neutral commercial brands with more and less contagious laugher. Five hypotheses were tested comparing explicit (measured with semantic differential) and implicit attitudes (measured by evaluative priming and electromyographic amplitude -EMG- of the zygomatic muscle) between pre- and postconditioning and between commercial brands conditioned with more vs less contagious laugher. Concerning the baseline, there were greater explicit postconditioning attitudes towards commercial brands paired with more contagious laughter; no explicit attitudinal differences were found between brands conditioned with more vs. less contagious laughter. Only implicit attitudinal differences were evidenced between pre- and postconditioning for the commercial brand paired with the most contagious male laughter. No differences in the zygomatic EMG amplitude were observed between pre- and postconditioning or between commercial brands paired with more vs. less contagious laughter. We conclude that contagious laughter has the capacity to transfer affective valence to neutral stimuli and that concordance is not always observed between explicit and implicit postconditioning attitudes.

La risa contagiosa como vocalización provocadora de expresiones faciales y electromiográficas relacionadas con emociones positivas en los oyentes / Contagious laughter as a provocative vocalization of facial and electromyographic expressions related to positive emotions in listeners

Resumen A pesar de su relevancia para la comprensión de la expresión emocional vocal, el estudio de la risa contagiosa se encuentra en sus primeras etapas de investigación y aún no se ha establecido su naturaleza ni la de las respuestas que esta provoca. Teniendo esto en cuenta, el propósito de este estudio fue determinar si los estímulos acústicos de risa contagiosa, además de generar conductas de risa o sonrisa, provocan en los oyentes las expresiones faciales, electromiográficas y cardíacas de una emoción positiva. Para esto, se contó con la participación de 60 universitarios de ambos sexos con edades entre los 18 y los 30 años en un diseño experimental intrasujeto con mediciones en la condición de línea de base y en exposiciones a diferentes estímulos de risa contagiosa, donde se verificaron tres hipótesis en las que se comparó expresiones faciales de alegría (medidas con el software FaceReader), amplitud electromiográfica (EMG) del músculo cigomático mayor (medida con el módulo EMG-100 del Biopac) e intervalos R-R como indicadores de frecuencia cardíaca (medidos con el módulo ECG-100 del Biopac) entre las diferentes condiciones. Como resultado, se encontraron diferencias significativas en los porcentajes de las expresiones faciales de alegría y amplitud EMG del cigomático al comparar las condiciones de línea de base y estímulos de risa más contagiosa, y de risas más y menos contagiosas; no obstante, no se encontraron diferencias significativas en los intervalos R-R en ninguna de las condiciones comparadas. Como conclusión, se comprobó la naturaleza emocional positiva de la risa/sonrisa provocada por estímulos de risa contagiosa y la proporcionalidad entre la intensidad de las expresiones faciales y las respuestas EMG elicitadas por esta risa y el grado de contagio percibido de la misma.

Abstract Despite its relevance for the understanding of vocal emotional expression, the study of contagious laughter is in its early stages of research and neither its nature nor the nature of the responses it provokes have not yet been established. The purpose of this study was to determine whether the acoustic stimuli of contagious laughter, in addition to generating laughter or smiling behaviors, elicit in listeners the facial, electromyographic and heart expressions of a positive emotion. To this end, 60 university students of both sexes, aged between 18 and 30 years participated in an intrasubject experimental design with measurements in the baseline condition and in exposures to different contagious laughter stimuli, where three hypotheses were tested comparing facial expressions of joy (measured with the FaceReader software), electromyographic amplitude (EMG) of the zygomaticus major muscle (measured with the Biopac EMG-100 module) and RR intervals as indicators of heart rate (measured with the Biopac ECG-100 module) between the different conditions. As a result, significant differences were found in the percentages of facial expressions ofjoy and zygomatic EMG amplitude when comparing the baseline and stimulus conditions of more contagious laughter, and more and less contagious laughter. However, no significant differences were found in the R-R intervals in any of the compared conditions. In conclusion, the positive emotional nature of laughter / smile caused by contagious laughter stimuli and the proportionality between the intensity of the facial expressions and EMG responses elicited by this laughter and the perceived degree of contagiousness of laughter were verified.

Asociación entre mortalidad por Covid-19 y contaminación atmosférica en ciudades mexicanas / Association between Covid-19 mortality and atmospheric pollution in Mexican cities

Resumen: Objetivo: Analizar la asociación entre la exposición crónica a contaminantes atmosféricos y la tasa de mortalidad por Covid-19 en ciudades mexicanas. Material y métodos: Estudio ecológico en 25 ciudades mexicanas utilizando el reporte de casos diarios de muertes por Covid-19 (febrero a junio 2020) y datos validados de contaminantes atmosféricos, considerando concentraciones promedio en cada ciudad en el último año. Se utilizaron modelos de regresión Poisson, con modelos aditivos generalizados y variables de ajuste. Resultados: Se encontró un incremento significativo de 3.5% (IC95% 2.3-4.7) en la tasa de mortalidad por Covid-19 por incremento de 1µg/m3 de NO2. La asociación con PM2.5 fue no significativa, con un incremento de 1.8% por cada µg/m3. Conclusiones: Los resultados sugieren una asociación entre la mortalidad por Covid-19 y la exposición a NO2. Esta primera aproximación del riesgo asociado con la contaminación del aire requiere de análisis más precisos, pero es consistente con estudios de otras regiones.

Abstract Objective: To analyze the relationship between chronic exposures to air pollution with Covid-19 death rate in Mexican cities. Materials and methods: Ecological study in 25 Mexican cities using the report of daily Covid-19 deaths (from February to June 2020) and validated data of air pollutants, considering average concentrations in each city for the last year. Poisson regression models using generalized additive models with adjustment variables (GAM) were used. Results: A significant increase of 3.5% (95% CI 2.3-4.7) was found in Covid-19 death rate for each 1µg/m3 in annual concentration of NO2. The association with PM2.5 was not significant, with an increase of 1.8% for each 1µg/m3. Conclusions: Results suggest an association between Covid-19 mortality and chronic exposure to NO2. This first approximation of the risk associated with air pollution requires a more precise analysis, but is consistent with what was observed in other studies.

Asociación entre mortalidad por Covid-19 y contaminación atmosférica en ciudades mexicanas.

Objetivo. Analizar la asociación entre la exposición crónica a contaminantes atmosféricos y la tasa de mortalidad por Covid-19 en ciudades mexicanas. Material y métodos. Estudio ecológico en 25 ciudades mexicanas utilizando el reporte de casos diarios de muertes por Covid-19 (febrero a junio 2020) y datos validados de contaminantes atmosféricos, considerando concentraciones promedio en cada ciudad en el último año. Se utilizaron modelos de regresión Poisson, con modelos aditivos generalizados y variables de ajuste. Resultados. Se encontró un incremento significativo de 3.5% (IC95% 2.3-4.7) en la tasa de mortalidad por Covid-19 por incremento de 1µg/m3 de NO2. La asociación con PM2.5 fue no significativa, con un incremento de 1.8% por cada µg/ m3. Conclusiones. Los resultados sugieren una asociación entre la mortalidad por Covid-19 y la exposición a NO2. Esta primera aproximación del riesgo asociado con la contami-nación del aire requiere de análisis más precisos, pero es consistente con estudios de otras regiones.

Infección comunitaria por Clostridium difficile asociada a colitis ulcerativa idiopática / Community Clostridium difficile infection associated to idiopathic ulcerative colitis

RESUMEN Clostridium difficile es una bacteria relacionada con la colitis, asociada a antibióticos y a la diarrea adquirida en pacientes hospitalizados. Sin embargo, su comportamiento ha cambiado en los últimos años, hasta el punto de ser considerada un problema de salud mundial. Su curso clínico varía desde casos asintomáticos, colitis, hasta complicaciones que ponen en peligro la vida del paciente. Dentro de los factores de riesgo descritos se encuentra la enfermedad inflamatoria intestinal, especialmente la colitis ulcerativa idiopática. El caso reportado versa sobre la presentación de esta infección asociada a un brote de colitis ulcerativa en un paciente joven, sin antecedentes de enfermedad inflamatoria intestinal, consumo de antibióticos ni hospitalización (AU).

ABSTRACT Clostridium difficile is a bacterium related to antibiotic-associated colitis and to diarrhea acquired in hospitalized patients. However, its behavior has changed in recent years to the point of being considered as a global health problem. Its clinical course ranges from asymptomatic cases, colitis, to complications with risk for the patient's life. The inflammatory bowel disease, especially idiopathic ulcerative colitis is found among the described risk factors. The case reported deals with the presentation of this infection associated to an outbreak of ulcerative colitis in a young patient, with no previous history of inflammatory bowel disease, consumption of antibiotics or hospitalization (AU).

Páncreas ectópico en antro gástrico asociado a síntomas de reflujo. Reporte de un caso / Ectopic pancreas in gastric antrum associated to reflux symptoms. Report of a case

RESUMEN El páncreas ectópico es una entidad poco común. Como tumor submucoso de origen congénito, frecuentemente presenta un curso asintomático, aunque con posibles complicaciones. Su diagnóstico de certeza se basa en la endoscopia, el ultrasonido endoscópico y la histología, que permiten adoptar una conducta expectante o quirúrgica. El paciente estudiado presentó un páncreas ectópico localizado en antro gástrico asociado a síntomas de reflujo gastroesofágico rebeldes a tratamiento, los cuales motivaron el estudio endoscópico, con el consecuente hallazgo de dicha entidad (AU).

ABSTRACT Ectopic pancreas is a little common entity. As congenital-originated sub mucous tumor, it frequently presents an asymptomatic course, though with possible complications. Its definitive diagnosis is based in the endoscopy, endoscopic ultrasound and histology, allowing to adopt an expectant or surgical behavior. The current patient presented an unresponsive-to-treatment ectopic pancreas located in the gastric antrum associated to gastro-esophageal reflux symptoms. This motivated the endoscopic study consequently leading to finding this entity (AU).

Revisión rápida de los efectos de la variación de la temperatura y la humedad en la morbilidad y mortalidad por Covid-19 / Rapid review of the effects of temperature and humidity variation on the Covid-19 morbidity and mortality

Resumen: Objetivo: Resumir y analizar la evidencia de la asociación entre Covid-19 y factores climáticos. Material y métodos: Se utilizó la metodología de revisiones rápidas de Cochrane. Se buscaron artículos publicados del 1 de enero al 27 de abril de 2020 en una base de datos académica y preprints. Los títulos y resúmenes fueron revisados por dos investigadores y los textos completos por cinco investigadores. Resultados: De 354 artículos identificados, 26 cumplieron los criterios de elegibilidad establecidos. De éstos, 20 observaron una asociación inversa. Al evaluar su calidad, nueve calificaron con validez moderada, porque si bien ajustaron por covariables en el análisis, son estudios ecológicos. Conclusiones: A pesar de la homogeneidad de resultados, los factores climáticos explican un porcentaje pequeño de la variación de Covid-19. Son necesarios estudios con periodo de análisis más largo que capten tendencia y estacionalidad e incluyan factores de riesgo individuales.

Abstract: Objective: To summarize and analyze the evidence of the association between Covid-19 and climatic factors Materials and methods: We used the Cochrane rapid review methodology. An academic database and preprints were examined with the searches restricted from January 1 to April 27. Titles and abstracts were reviewed by two researchers and full texts were reviewed by the five authors. Results: We identified 354 articles, 26 met the established eligibility criteria. Of these, 20 reported an inverse association. When evaluating their quality, nine were qualified with moderate validity, this is because they adjusted for covariates in the analysis, but they are ecological studies. Conclusions: Despite homogeneity of results, climatic factors explained a small percentage of Covid-19 incidence variability. Future studies need to include individual risk factors and longer period of data to capture trend or seasonality.

[Association between Covid-19 mortality and atmospheric pollution in Mexican cities]. / Asociación entre mortalidad por Covid-19 y contaminación atmosférica en ciudades mexicanas.

Objective. To analyze the relationship between chronic exposures to air pollution with Covid-19 death rate in Mexican cities. Materials and methods. Ecological study in 25 Mexican cities using the report of daily Covid-19 deaths (from February to June 2020) and validated data of air pollutants, considering average concentrations in each city for the last year. Poisson regression models using generalized additive models with adjustment variables (GAM) were used. Results. A significant increase of 3.5% (95% CI 2.3-4.7) was found in Covid-19 death rate for each 1µg/m3 in annual concentration of NO2. The association with PM2.5 was not significant, with an increase of 1.8% for each 1µg/m3. Conclusions. Results suggest an association between Covid-19 mortality and chronic exposure to NO2. This first approximation of the risk associated with air pollution requires a more precise analysis, but is consistent with what was observed in other studies.

Overview of New Treatments with Immunotherapy for Breast Cancer and a Proposal of a Combination Therapy.

According to data from the U.S. National Cancer Institute, cancer is one of the leading causes of death worldwide with approximately 14 million new cases and 8.2 million cancer-related deaths in 2018. More than 60% of the new annual cases in the world occur in Africa, Asia, Central America, and South America, with 70% of cancer deaths in these regions. Breast cancer is the most common cancer in women, with 266,120 new cases in American women and an estimated 40,920 deaths for 2018. Approximately one in six women diagnosed with breast cancer will die in the coming years. Recently, novel therapeutic strategies have been implemented in the fight against breast cancer, including molecules able to block signaling pathways, an inhibitor of poly [ADP-ribose] polymerase (PARP), growth receptor blocker antibodies, or those that reactivate the immune system by inhibiting the activities of inhibitory receptors like cytotoxic T-lymphocyte antigen 4 (CTLA-4) and programmed death protein 1 (PD-1). However, novel targets include reactivating the Th1 immune response, changing tumor microenvironment, and co-activation of other components of the immune response such as natural killer cells and CD8+ T cells among others. In this article, we review advances in the treatment of breast cancer focused essentially on immunomodulatory drugs in targeted cancer therapy. Based on this knowledge, we formulate a proposal for the implementation of combined therapy using an extracorporeal immune response reactivation model and cytokines plus modulating antibodies for co-activation of the Th1- and natural killer cell (NK)-dependent immune response, either in situ or through autologous cell therapy. The implementation of "combination immunotherapy" is new hope in breast cancer treatment. Therefore, we consider the coordinated activation of each cell of the immune response that would probably produce better outcomes. Although more research is required, the results recently achieved by combination therapy suggest that for most, if not all, cancer patients, this tailored therapy may become a realistic approach in the near future.