Clinical and epidemiological features of patients with COVID-19 reinfection: a systematic review.

Recurrent positivity in a patient with COVID-19 may be due to various reasons, not necessarily reinfection. There is concern about the occurrence frequency of reinfection. Five databases and a preprint/preprint repository were searched. All case reports, case series, and observational studies were included. Bias was assessed for each study with the Newcastle-Ottawa Scale tool and reported according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA-2020). After eligibility, 77 studies were included for qualitative synthesis (52 case reports, 21 case series, and four case-controls; 1131 patients included). Of these, 16 studies described a second contact with the SARS-CoV-2 positive case, five studies described healthcare profession-related infection, ten studies described that the source of reinfection was likely to be from the community, one study described travel-related infection, nine studies described vulnerability-related infection due to comorbidity. The mean number of days from discharge or negative test to reinfection ranged from 23.3 to 57.6 days across the different included studies. The risk of bias for all case report/series studies was moderate/high. For observational studies, the risk of bias was low. Reinfection of patients with COVID-19 occurs between the first and second month after the first infection, but beyond, and 90 days have been proposed as a point to begin to consider it. The main factor for reinfection is contact with COVID-19 positive cases.

Lesiones etmoidales con extensión secundaria: estrategia quirúrgica y complicaciones / Ethmoidal lesions with secondary extension: surgical strategies and complications

Introduction: The removal of ethmoidal tumors with secondary extension to the cranial base and/or facial region involves a high complexity and it is associated to a high morbility. Objective: To determine the results of craniofacial surgery in patient with ethmoid extended tumors. Methods: It was carried out a traverse retrospective descriptive study. The sample was conformed by the patients intervened surgically of anterior cranial base lesions by means of a combined craneofacial surgery during the period: January of the 2009 to January of the 2012 in the National Institute of Oncology and Radiobiology with a 2 year pursuit. Descriptive statistical variables were used. Results: 20 patients were intervened. The age average was of 44,8 years. It prevail the masculine sex (65 percent). Nasal obstruction constitutes the most frequent presentation. Adenocarcinoma and epidermoid carcinoma constituted the most frequent malignant lesions. Inside the benign lesions prevail the invertedpapiloma. The techniques more employees were the bilateral frontal craneotomy and total etmoidectomy. The most frequent complication was the cerebrospinal fluid leak. The 2 years overall survival in patients with malignant lesions was 35 percent. Conclusions: A high number of complications was identified but they didn’t affect the survival neither the quality of life. An acceptable rate of survival was achieved in malignant lesions.

Introducción: La remoción de lesiones etmoidales con extensión secundaria a la base cranealy/o región facial, entraña una elevada complejidad y se encuentra asociada a una elevada morbilidad. Objetivo: Determinar los resultados de la cirugía combinada craneofacial en pacientes con neoplasias etmoidales extendidas. Métodos: Se realizó un estudio descriptivo retrospectivo transversal. La muestra estuvo conformada por los pacientes intervenidos quirúrgicamente de lesiones de base craneal anterior mediante un abordaje combinado craneofacial durante el período: enero de 2009 a enero de 2012 en el Instituto Nacional de Oncología y Radiobiología con un seguimiento de 2 años. Se emplearon variables estadísticas descriptivas. Resultados: Fueron intervenidos 20 pacientes. El promedio de edad fue de 44,8 años. Predominó el sexo masculino (65 por ciento). La obstrucción nasal constituyó la presentación más frecuente. El adenocarcinoma y el carcinoma epidermoide constituyeron las lesiones malignas más frecuentes. Dentro de las lesiones benignas predominó el papiloma invertido. Las técnicas más empleadas fueron la craneotomía frontal bilateral y la etmoidectomía total. La complicación más frecuente fue la fístula de líquido cefalorraquídeo. La supervivencia global a los 2 años en los pacientes con lesiones malignas fue del 35 por ciento. Conclusiones: Se identificó un elevado número de complicaciones pero no afectaron la supervivencia ni la calidad de vida. Se logró una aceptable tasa de supervivencia en lesiones malignas.

Evaluación de los efectos antioxidante, antibacteriano y antifúngico de Calophyllum Brasilense Cambes (Lagarto Caspi) / Evaluation of antioxidant effects, antibacterial and antifungal Brasilense Calophyllum Cambes (Caspi Lizard)

Objetivo: Evaluar el efecto antibacteriano, antifúngico y antioxidante de diferentes extractos del Calophyllum brasiliense Cambess. Material y Métodos: El efecto antioxidante fue determinado por captación de radicales libres, midiendo la decoloración de una solución de 2,2-difenil-1-picril hidrazilo (DPPH); La actividad antibacteriana y antifúngica, in Vitro, se determinó mediante la prueba de dilución. El efecto antibacteriano se evaluó en cepas de E. coli ATCC25922 y Staphylococcus aureus ATCC25923, utilizando medios de cultivo: Caldo y Agar Mueller Hinton. Para evaluar el efecto antifúngico, se utilizó cepas de Cándida albicans en medio de Agar Sabouraud. Resultados: La actividad antioxidante de los extractos acuoso, metanólico y etanólico fue muy satisfactoria, siendo de 110.56 por ciento, 99.17 por ciento y 99.57 por ciento, respectivamente, a una concentración de 100 ug/mL, en comparación con la Vitamina C que presentó 86,5 por ciento. Asimismo, observamos un buen efecto antifúngico para los extractos acuoso y etanólico al 20 por ciento p/v a los volúmenes de 3, 3.5 y 4mL. y en el caso del extracto etanólico también presentó un buen efecto a una concentración del 10 por ciento a un volumen de 1.6mL. Conclusiones: Los extractos: acuoso, metanólico y etanólico, presentaron un buen efecto antioxidante y antifúngico, en las cepas estudiadas.

Objetive: To evaluate, in vitro, the antibacterial, antifungal andantioxidant effects of different extracts of Calophyllum brasiliense Cambess. Material and Methods: The antioxidant effect was tested by free radicals capture, measuring discoloration of the 2,2-diphenyl-1-pycryl hydrazyle solution (DPPH). We used a dilution to measure antibacterial and antifungal in vitro activity. Strains of E. coli ATCC25922 and Staphylococcus aureus ATCC25923 were used to evaluate antibacterial effect; using Broth and Mueller Hinton Agar as culture medium. Strains of Candida albicans and Agar Sabouraud as culture medium were usedto evaluate antifungal effect. Results: Aqueous, methanolic and ethanolic extracts, showed good antioxidant activity having 110.56 per cent, 99.17 per cent and 99.57 per cent of antioxidant activity at 100 ug/mL concentration, respectively. This is superior to the vitamin C referencepattern that showed 86,5 per cent activity. Good antifungal effect for aqueous and ethanol extracts at a 20 per cent concentration for 3, 3.5 and 4 ml of volume was determined. Ethanol extracts had the same antifungal effect at a 10 per cent concentration for 1.6mL. of volume. Conclusions: The aqueous, methanolic and ethanolic extracts showed a good antioxidant and antifungal activity on the strains studied.

A mutation in human VAP-B--MSP domain, present in ALS patients, affects the interaction with other cellular proteins.

Amyotrophic Lateral Sclerosis (ALS) is the most common adult-onset Motor Neuron Disease (MND), characterized by motor neurons death in the cortex, brainstem and spinal cord. Ten loci linked to Familial ALS have been mapped. ALS8 is caused by a substitution of a proline by a serine in the Vesicle-Associated Membrane Protein-Associated protein-B/C (VAP-B/C). VAP-B belongs to a highly conserved family of proteins implicated in Endoplasmic Reticulum-Golgi and intra-Golgi transport and microtubules stabilization. Previous studies demonstrated that the P56S mutation disrupts the subcellular localization of VAP-B and that this position would be essential for Unfolded Protein Response (UPR) induced by VAP-B. In the present work we expressed and purified recombinant wild-type and P56S mutant VAP-B-MSP domain for the analysis of its interactions with other cellular proteins. Our findings suggest that the P56S mutation may lead to a less stable interaction of this endoplasmic reticulum protein with at least two other proteins: tubulin and GAPDH. These two proteins have been previously related to other forms of neurodegenerative diseases and are potential key points to understand ALS8 pathogenesis and other forms of MND. Understanding the role of these protein interactions may help the treatment of this devastating disease in the future.

Analysis of the Saccharomyces cerevisiae exosome architecture and of the RNA binding activity of Rrp40p.

The exosome is a complex of eleven subunits in yeast, involved in RNA processing and degradation. Despite the extensive in vivo functional studies of the exosome, little information is yet available on the structure of the complex and on the RNase and RNA binding activities of the individual subunits. The current model for the exosome structure predicts the formation of a heterohexameric RNase PH ring, bound on one side by RNA binding subunits, and on the opposite side by hydrolytic RNase subunits. Here, we report protein-protein interactions within the exosome, confirming the predictions of constituents of the RNase PH ring, and show some possible interaction interfaces between the other subunits. We also show evidence that Rrp40p can bind RNA in vitro, as predicted by sequence analysis.

Do multi-sectoral development programmes affect health? A Bolivian case study.

This cross-sectional study, carried out in Inquisivi, Bolivia, a rural area where Save the Children/US works, tests the hypothesis that participation in multisectoral development programmes results in improved health behaviours and better health outcomes. To test this hypothesis, four groups of households were compared: those participating in Save the Children's health-only programmes; those with access to health and micro-enterprise credit or health and literacy programmes; those participating in all three programmes (health, credit and literacy); and households from comparison communities (no access to any of Save the Children's programmes). Data come from a stratified sample of 499 households in the altiplano, foothills and valleys of the Andes. Findings reported here suggest that there is no clear association between participation in one or more of Save the Children's programmes and parents' actions to prevent and treat diarrhoea. Additionally, the point prevalence of diarrhoea was similar for all four groups. However, children of individuals participating in health, credit and literacy were significantly less likely than children from comparison communities to be malnourished or at risk of becoming malnourished, even after controlling for such potentially confounding factors as social class, source of drinking water, and the availability of health facilities.

[The atrioventricular canal and vascular ring. The surgical treatment of a rare anatomical association]. / Canale atrioventricolare e anello vascolare. Trattamento chirurgico di una rara associazione anatomica.

We report the clinical and surgical data of 11 patients with atrioventricular canal and vascular ring. Down syndrome was present in 8 cases (72.7%); 8 patients were female (72.7%). Seven patients underwent, at the same time, correction of vascular ring and banding of the pulmonary artery with 4 death. Two children underwent correction of vascular ring and subsequent correction of atrioventricular canal without mortality. Two patients underwent correction of atrioventricular canal and subsequent correction of the vascular ring with one death. The mortality of the 6 patients operated after the age of 6 months was in measure of 16.6%. This association of malformations may be due to anomalies of neural crest and, although rare, should be particularly kept in mind referring to female patients with Down syndrome.

Malaria por plasmodium falciparum en Madre de Dios / Malariae due to plasmodium falciparum in Madre de Dios

De Enero a Abril de 1990, se presentaron en Puerto Maldonado, departamento de Madre de Dios, 6 casos de malaria por Plasmodium falciparum, tres de ellos mortales. En Mayo del mismo año, llevamos a cabo un estudio seroepidemiológico en 175 individuos de la zona urbana y rural de Puerto Maldonado, con el fin de conocer la prevalencia de anticuerpos a P. falciparum en esa población. Nueve individuos (5.14 por ciento) tenían anticuerpos a P. falciparum; 2 eran brasileños y 7 eran peruanos. Dos de estos últimos se encontraban en la fase aguda de la enfermedad, identificándose P. falciparum en láminas de frotis sanguíneo. Ninguno había estado en alguna zona endémica para esa enfermedad, por lo cual consideramos que constituyen casos autóctonos de malaria por P. falciparum. Se recomienda realizar otros estudios epidemiológicos así como pruebas de sensibilidad a las diferentes cepas de P. falciparum que se encuentren en Madre de Dios. Además, se hace necesaria la identificación de los vectores y la especie de Plasmodium que transmiten

Hipertiroidismo neonatal: errores en el diagnóstico / Neonatal hyperthyroidism: diagnostic errors

Se presenta el caso de un lactante de dos meses de edad que es traído a consulta por presentar deposiciones semilíquidas desde su nacimiento, y regurgitaciocnes. Al examen le detectan una frecuencia cardiaca de 160 latidos por minuto, y una exoftalmia bilateral. Los resultados de T4 y T3 son de 15 ug% y 200 ng% respectivamente por lo que se le diagnostica de hipertiroidismo neonatal siendo tratado con beta-bloqueadores y antitiroideos. Al revaluar el caso, por los autores del reporte, se demostró que las deposiciones semilíquidas y las regurgitaciones es consecuencia de la lactancia materna exclusiva a la cual era mantenida el lactante. La frecuencia cardiaca se encuentra dentro del rango de normalidad para la edad, lo mismo que los niveles de hormonas tiroideas. La interconsulta a oftalmología no demostró la existencia de exoftalmos, por lo cual se diagnosticó erroneamente de hipertiroidismo neonatal a un lactante eutriroideo