Demography and Behaviour of Teinopodagrion oscillans (Odonata: Megapodagrionidae) in a Protected Area of the Colombian Andean Region.

The demography and behaviour of Teinopodagrion oscillans was studied in a protected area in the Andean region of Colombia. Adult damselflies were individually marked, and using their recapture histories, we estimated survival, longevity, sex ratio, and population size using Cormack-Jolly-Seber models. Other aspects of their behaviour were recorded. Survival, recapture, and lifespan (14.1 ± 0.59 days) were similar for both sexes and all age groups. Mature males were larger, and the distance from the water was similar for all individuals. The most supported model was the time-dependent model for survival and recapture. This suggests that weather variations affect the demography of this population in a significant way. Individuals exhibited high fidelity to their site perch, perching with open wings near water on a variety of perches. Mature males make short flights from the perch to intercept conspecific and interspecific males and to hunt prey. The tandem position was formed on macrophytes, and then the pair flew away. Oviposition lasted for 11.23 min on average, with the females ovipositing by abdomen submersion. Our results offer insights into the demographic characteristics and behaviour of this species, providing crucial information for the short- and long-term, from the demography of one species to the conservation of ecosystems of the Andean region.

Associations between posttraumatic stress and stroke: A systematic review and meta-analysis.

The objective of the present study was to systematically review the existing literature for studies examining the association between posttraumatic stress disorder (PTSD) and stroke risk and perform a meta-analysis to obtain a pooled risk estimate describing the association. A literature search was conducted in PubMed, Embase, PSYCInfo, and CINAHL to identify relevant studies. Cohort and cross-sectional studies that reported PTSD exposure (i.e., PTSD diagnosis, probable PTSD, or the presence of PTSD symptoms) at baseline and the risk or odds of stroke associated with PTSD exposure during the study period were included in the analysis. A random-effects model was used to calculate the pooled hazard ratio (HR) for cohort studies estimating the association between PTSD and stroke. Overall, 11 studies met the inclusion criteria; eight were cohort studies, and three were cross-sectional studies. Two cohort studies and all cross-sectional studies used self-report of PTSD symptoms to measure the exposure. The pooled hazard ratio for the eight cohort studies showed that having PTSD was associated with a 59% higher risk of incident stroke, HR = 1.59, 95% CI [1.36, 1.86], I2 = 81%. The association remained statistically significant in a subgroup analysis of six United States-based studies, HR = 1.38; 95% CI [1.29, 1.49], I2 = 18%. The findings suggest that PTSD is associated with an increased risk of stroke. More studies are required to explore a causal association between PTSD and stroke.

Association of inpatient rehabilitation with functional outcome in patients with stroke receiving mechanical thrombectomy.

INTRODUCTION: Patients with ischemic strokes that have undergone mechanical thrombectomy (MT) can still have poor functional outcomes. Limited research exists on factors that impact functional outcomes in these patients who are discharged to inpatient rehabilitation. We examined patient characteristics correlated with 90-day outcomes in ischemic stroke patients having undergone MT and undergo acute rehabilitation. METHODS: This is a retrospective study of patients (≥18 years) who were consecutively admitted to inpatient rehabilitation after undergoing MT following an ischemic stroke event from 2015 through 2018. Functional outcomes at 90-days were determined by the modified Rankin Score (mRS). Binary logistic regression models were used to measure the association of meaningful Functional Independence Measure (FIM) change with poor-outcome (mRS >2). RESULTS: Out of 56 stroke patients undergoing MT, 36 had poor outcome (mRS >2) at 90-days. One unit increase in discharge FIM significantly decreased the likelihood of poor outcome by 4% [aOR = 0.96; 95% CI = 95% CI = 0.92, 0.99]. Admission FIM [aOR = 0.95; 95% CI = 0.90, 1.00] and change in FIM [aOR = 0.97; 95% CI = 0.93, 1.02] were not significantly associated poor outcome in the adjusted models. CONCLUSION: Patients with ischemic stroke who received MT who have a worse disability, particularly at discharge, while undergoing inpatient rehabilitation have higher odds of having poor future functional outcomes. This was regardless of age, sex, or race. Future research is needed to understand the mechanisms that can improve functional performance in our patient population at the IRF.

Immune activation during pregnancy exacerbates ASD-related alterations in Shank3-deficient mice.

BACKGROUND: Autism spectrum disorder (ASD) is mainly characterized by deficits in social interaction and communication and repetitive behaviors. Known causes of ASD are mutations of certain risk genes like the postsynaptic protein SHANK3 and environmental factors including prenatal infections. METHODS: To analyze the gene-environment interplay in ASD, we combined the Shank3Δ11-/- ASD mouse model with maternal immune activation (MIA) via an intraperitoneal injection of polyinosinic/polycytidylic acid (Poly I:C) on gestational day 12.5. The offspring of the injected dams was further analyzed for autistic-like behaviors and comorbidities followed by biochemical experiments with a focus on synaptic analysis. RESULTS: We show that the two-hit mice exhibit excessive grooming and deficits in social behavior more prominently than the Shank3Δ11-/- mice. Interestingly, these behavioral changes were accompanied by an unexpected upregulation of postsynaptic density (PSD) proteins at excitatory synapses in striatum, hippocampus and prefrontal cortex. LIMITATIONS: We found several PSD proteins to be increased in the two-hit mice; however, we can only speculate about possible pathways behind the worsening of the autistic phenotype in those mice. CONCLUSIONS: With this study, we demonstrate that there is an interplay between genetic susceptibility and environmental factors defining the severity of ASD symptoms. Moreover, we show that a general misbalance of PSD proteins at excitatory synapses is linked to ASD symptoms, making this two-hit model a promising tool for the investigation of the complex pathophysiology of neurodevelopmental disorders.

The ADORA1 mutation linked to early-onset Parkinson's disease alters adenosine A1-A2A receptor heteromer formation and function.

Adenosine modulates neurotransmission through inhibitory adenosine A1 receptors (A1Rs) and stimulatory A2A receptors (A2ARs). These G protein-coupled receptors are involved in motor function and related to neurodegenerative diseases such as Parkinson's disease (PD). An autosomal-recessive mutation (G2797.44S) within the transmembrane helix (TM) 7 of A1R (A1RG279S) has been associated with the development of early onset PD (EOPD). Here, we aimed at investigating the impact of this mutation on the structure and function of the A1R and the A1R-A2AR heteromer. Our results revealed that the G2797.44S mutation does not alter A1R expression, ligand binding, constitutive activity or coupling to transducer proteins (Gαi, Gαq, Gα12/13, Gαs, ß-arrestin2 and GRK2) in transfected HEK-293 T cells. However, A1RG279S weakened the ability of A1R to heteromerize with A2AR, as shown in a NanoBiT assay, which led to the disappearance of the heteromerization-dependent negative allosteric modulation that A1R imposes on the constitutive activity and agonist-induced activation of the A2AR. Molecular dynamic simulations allowed to propose an indirect mechanism by which the G2797.44S mutation in TM 7 of A1R weakens the TM 5/6 interface of the A1R-A2AR heteromer. Therefore, it is demonstrated that a PD linked ADORA1 mutation is associated with dysfunction of adenosine receptor heteromerization. We postulate that a hyperglutamatergic state secondary to increased constitutive activity and sensitivity to adenosine of A2AR not forming heteromers with A1R could represent a main pathogenetic mechanism of the EOPD associated with the G2797.44S ADORA1 mutation.

Trans-cardiac perfusion of neonatal mice and immunofluorescence of the whole body as a method to study nervous system development.

Whole animal perfusion is a well-established method that has been used for the past decades in multiple research fields. Particularly, it has been very important for the study of the brain. The rapid and uniform fixation of tissue is essential for the preservation of its integrity and the study of complex structures. For small tissue pieces submerging in formaldehyde solution oftentimes is sufficient to get a good fixation, larger tissues or organs with a more complicated structure present a greater difficulty. Here, we report the precise parameters to successfully perform trans-cardiac perfusion of neonatal mouse pups that allows a uniform fixation of the whole body for subsequent structural analysis and immunohistochemistry. In comparison to standard perfusion procedures of adult mice, changes in the pump velocity, the buffer volume and in the needle size lead to high quality fixation of neonatal mice pups. Further, we present a whole-body section staining, which results in a highly specific immunofluorescence signal suited for detailed analysis of multiple tissues or systems at the same time. Thus, our protocol provides a reproducible and reliable method for neonatal perfusion and staining that can rapidly be applied in any laboratory. It allows a high quality analysis of cellular structures and expression profiles at early developmental stages.

SHANK3 deficiency leads to myelin defects in the central and peripheral nervous system.

Mutations or deletions of the SHANK3 gene are causative for Phelan-McDermid syndrome (PMDS), a syndromic form of autism spectrum disorders (ASDs). We analyzed Shank3Δ11(-/-) mice and organoids from PMDS individuals to study effects on myelin. SHANK3 was found to be expressed in oligodendrocytes and Schwann cells, and MRI analysis of Shank3Δ11(-/-) mice revealed a reduced volume of the corpus callosum as seen in PMDS patients. Myelin proteins including myelin basic protein showed significant temporal and regional differences with lower levels in the CNS but increased amounts in the PNS of Shank3Δ11(-/-) animals. Node, as well as paranode, lengths were increased and ultrastructural analysis revealed region-specific alterations of the myelin sheaths. In PMDS hiPSC-derived cerebral organoids we observed an altered number and delayed maturation of myelinating cells. These findings provide evidence that, in addition to a synaptic deregulation, impairment of myelin might profoundly contribute to the clinical manifestation of SHANK3 deficiency.

SHANK2 Mutations Result in Dysregulation of the ERK1/2 Pathway in Human Induced Pluripotent Stem Cells-Derived Neurons and Shank2(-/-) Mice.

SHANK2 (ProSAP1) is a postsynaptic scaffolding protein of excitatory synapses in the central nervous system and implicated in the development of autism spectrum disorders (ASD). Patients with mutations in SHANK2 show autism-like behaviors, developmental delay, and intellectual disability. We generated human induced pluripotent stem cells (hiPSC) from a patient carrying a heterozygous deletion of SHANK2 and from the unaffected parents. In patient hiPSCs and derived neurons SHANK2 mRNA and protein expression was reduced. During neuronal maturation, a reduction in growth cone size and a transient increase in neuronal soma size were observed. Neuronal proliferation was increased, and apoptosis was decreased in young and mature neurons. Additionally, mature patient hiPSC-derived neurons showed dysregulated excitatory signaling and a decrease of a broad range of signaling molecules of the ERK-MAP kinase pathway. These findings could be confirmed in brain samples from Shank2(-/-) mice, which also showed decreased mGluR5 and phospho-ERK1/2 expression. Our study broadens the current knowledge of SHANK2-related ASD. We highlight the importance of excitatory-inhibitory balance and mGluR5 dysregulation with disturbed downstream ERK1/2 signaling in ASD, which provides possible future therapeutic strategies for SHANK2-related ASD.

The Heart and COVID-19: What Cardiologists Need to Know. / O Coração e a COVID-19: O que o Cardiologista Precisa Saber.

In face of the pandemic of the novel coronavirus disease 2019 (COVID-19), the management of patients with cardiovascular risk factors and/or disease is challenging. The cardiovascular complications evidenced in patients with COVID-19 derive from several mechanisms, ranging from direct viral injury to complications secondary to the inflammatory and thrombotic responses to the infection. The proper care of patients with COVID-19 requires special attention to the cardiovascular system aimed at better outcomes.

Frente à pandemia da doença causada pelo novo coronavírus (COVID-19), o manejo do paciente com fator de risco e/ou doença cardiovascular é desafiador nos dias de hoje. As complicações cardiovasculares evidenciadas nos pacientes com COVID-19 resultam de vários mecanismos, que vão desde lesão direta pelo vírus até complicações secundárias à resposta inflamatória e trombótica desencadeada pela infecção. O cuidado adequado do paciente com COVID-19 exige atenção ao sistema cardiovascular em busca de melhores desfechos.

Agrobacterium rhizogenes-mediated transformation of grain (Amaranthus hypochondriacus) and leafy (A. hybridus) amaranths.

KEY MESSAGE: Transgenic A. hypochondriacus and A. hybridus roots were generated. Further, a distinct plant regeneration program via somatic embryos produced from hairy roots was established. Work was implemented to develop an optimized protocol for root genetic transformation of the three grain amaranth species and A. hybridus, their presumed ancestor. Transformation efficiency was species-specific, being higher in A. hypochondriacus and followed by A. hybridus. Amaranthus cruentus and A. caudatus remained recalcitrant. A reliable and efficient Agrobacteruim rhizogenes-mediated transformation of these species was established using cotyledon explants infected with the previously untested BVG strain. Optimal OD600 bacterial cell densities were 0.4 and 0.8 for A. hypochondriacus and A. hybridus, respectively. Hairy roots of both amaranth species were validated by the amplification of appropriate marker genes and, when pertinent, by monitoring green fluorescent protein emission or ß-glucuronidase activity. Embryogenic calli were generated from A. hypochondriacus rhizoclones. Subsequent somatic embryo maturation and germination required the activation of cytokinin signaling, osmotic stress, red light, and calcium incorporation. A crucial step to ensure the differentiation of germinating somatic embryos into plantlets was their individualization and subcultivation in 5/5 media containing 5% sucrose, 5 g/L gelrite, and 0.2 mg/L 2-isopentenyladenine (2iP) previously acidified to pH 4.0 with phosphoric acid, followed by their transfer to 5/5 + 2iP media supplemented with 100 mg/L CaCl2. These steps were strictly red light dependent. This process represents a viable protocol for plant regeneration via somatic embryo germination from grain amaranth transgenic hairy roots. Its capacity to overcome the recalcitrance to genetic transformation characteristic of grain amaranth has the potential to significantly advance the knowledge of several unresolved biological aspects of grain amaranths.

O Coração e a COVID-19: O que o Cardiologista Precisa Saber / The Heart and COVID-19: What Cardiologists Need to Know

Resumo Frente à pandemia da doença causada pelo novo coronavírus (COVID-19), o manejo do paciente com fator de risco e/ou doença cardiovascular é desafiador nos dias de hoje. As complicações cardiovasculares evidenciadas nos pacientes com COVID-19 resultam de vários mecanismos, que vão desde lesão direta pelo vírus até complicações secundárias à resposta inflamatória e trombótica desencadeada pela infecção. O cuidado adequado do paciente com COVID-19 exige atenção ao sistema cardiovascular em busca de melhores desfechos.

Abstract In face of the pandemic of the novel coronavirus disease 2019 (COVID-19), the management of patients with cardiovascular risk factors and/or disease is challenging. The cardiovascular complications evidenced in patients with COVID-19 derive from several mechanisms, ranging from direct viral injury to complications secondary to the inflammatory and thrombotic responses to the infection. The proper care of patients with COVID-19 requires special attention to the cardiovascular system aimed at better outcomes.

The Heart and COVID-19: What Cardiologists Need to Know

In face of the pandemic of the novel coronavirus disease 2019 (COVID-19), the management of patients with cardiovascular risk factors and/or disease is challenging. The cardiovascular complications evidenced in patients with COVID-19 derive from several mechanisms, ranging from direct viral injury to complications secondary to the inflammatory and thrombotic responses to the infection. The proper care of patients with COVID-19 requires special attention to the cardiovascular system aimed at better outcomes.

O Coração e a COVID-19: O que o Cardiologista Precisa Saber

Frente à pandemia da doença causada pelo novo coronavírus (COVID-19), o manejo do paciente com fator de risco e/ou doença cardiovascular é desafiador nos dias de hoje. As complicações cardiovasculares evidenciadas nos pacientes com COVID-19 resultam de vários mecanismos, que vão desde lesão direta pelo vírus até complicações secundárias à resposta inflamatória e trombótica desencadeada pela infecção. O cuidado adequado do paciente com COVID-19 exige atenção ao sistema cardiovascular em busca de melhores desfechos.

Estudo comparativo entre as alterações hemodinâmicas observadas na cintilografia miocárdica com dipiridamol combinado ou não ao exercício de baixa carga / Comparative study between hemodynamic changes observed on myocardial dipyridamole scintigraphy combined or not with low-load exercise

INTRODUÇÃO: A cintilografia de perfusão miocárdica (CPM) com dipiridamol é uma alternativa para a investigação de isquemia em pacientes que não conseguem se exercitar. Porém, os pacientes (p) submetidos a esta modalidade de estresse estão mais propensos à ocorrência de hipotensão arterial e outros sintomas decorrentes do seu efeito vasodilatador. O estresse misto, combinando o exercício de baixa carga na esteira com o vasodilatador se mostra uma alternativa, podendo predispor à menor ocorrência de para efeitos. OBJETIVOS E MÉTODOS: Estudo prospectivo avaliou 44 p de um hospital terciário que realizaram CPM com sestamibi-Tc-99m sendo submetidos em momentos diferentes às duas modalidades de estresse (dipiridamol isolado e em combinação com exercício de baixa carga). Os objetivos foram: avaliar a diferença na ocorrência de hipotensão arterial entre as duas modalidades de estresse considerando como significativa uma queda maior que 50 mmHg da pressão arterial sistólica (PAS) e/ou 20% da PAS basal e/ou valor absoluto da PAS ≤ 90 mmHg; avaliar a queda da PAS e a variação da frequência cárdica (FC) nas duas modalidades de estresse; verificar a interferência de variáveis clínicas na ocorrência de hipotensão arterial e variabilidade da FC < 20% durante o dipiridamol. A análise estatística foi realizada utilizando o teste de Mc Nemar para testar as proporções pareadas e o de Fisher para variáveis categóricas, considerando significativo se p <0,05. RESULTADOS: Observou-se queda significativa da PAS em 15,9% dos p submetidos ao dipiridamol e em 2,3% quando submetidos ao estresse misto, com tendência para a significância estatística (p=0,07). Se considerada qualquer queda da PAS notou-se significância estatística (p=0,043). Foi verificada maior variabilidade da FC no estresse misto com média de 73,1% (DP: 28,3%) em relação ao Dipiridamol, média de 29,1% (DP: 15,8%), p<0,001. Em relação àqueles com variabilidade da FC < 20% no dipiridamol, não se observou associação estatisticamente significativa com qualquer variável clínica de risco para doença arterial coronária (DAC). Não houve também associação estatística entre as variáveis de risco para DAC e a ocorrência de hipotensão arterial no dipiridamol. CONCLUSÃO: O estresse misto se mostrou uma alternativa viável uma vez que reduz a ocorrência de hipotensão arterial, apesar de não ter apresentado significância estatística para os critérios objetivos de queda da PA. A variabilidade da FC se mostrou maior no estresse misto não havendo associação significativa com as variáveis clínicas de risco para DAC. (AU)

Influencia de la obesidad sobre la resistencia y conductancia específica de la vía aérea en niños escolares / The impact of obesity on specific airway resistance and conductance among schoolchildren

Introducción. La obesidad infantojuvenil es un problema epidemiológico en los países en vías de desarrollo. Su prevalencia entre los niños en edad preescolar y escolar supera el 30%. Esta se asocia a una amplia variedad de complicaciones de salud, entre ellas, una acelerada pérdida de la función pulmonar, que provoca cambios en la fisiología y mecánica ventilatoria. El objetivo de este estudio fue estudiar la asociación entre obesidad y aumento de la resistencia específica de las vías aéreas (specific resistance airway; sRaw, por sus siglas en inglés) en una muestra infantojuvenil obesa de la comuna de Talca. Material y método. En una muestra de 36 sujetos con un promedio de edad de 9,38 ± 1,99 años, dividida en dos grupos, peso normal y obesos, se midieron los pliegues tricipital, subescapular, abdominal y volúmenes pulmonares. Para el análisis estadístico, se determinó la normalidad de los datos y, posteriormente, se utilizaron los test t de Student o U de Mann-Whitney y Pearson o Spearman según correspondiera. Se consideró un nivel de significancia estadística de p < 0,05. Resultados. Al comparar sujetos de peso normal con obesos, se observó un aumento significativo de la sRaw y una disminución significativa de la conductancia específica de la vía aérea en sujetos obesos. Además, se observó una correlación buena y significativa entre sRaw y porcentaje de grasa. Conclusiones. Los sujetos obesos mostraron un aumento de la sRaw y disminución de la conductancia específica de la vía aérea.

Introduction. Child and adolescent obesity is an epidemiological problem in developing countries. Its prevalence among preschoolers and schoolchildren is over 30%. It has been associated with a wide range of health complications, including rapid loss of lung function leading to changes in physiology and ventilatory mechanics. The objective of this study was to analyze the association between obesity and the increase in specific airway resistance (sRaw) in a sample of obese children and adolescents from the district of Talca. Material and method. In a sample of 36 subjects with an average age of 9.38 ± 1.99 years, divided into 2 groups (normal weight and obese), the tricipital, subscapular, and abdominal skinfolds and lung volumes were measured. For the statistical analysis, data normality was determined and then the Student's t test or the Mann-Whitney U test and Pearson's or Spearman's correlations were used, as applicable. A value of p < 0.05 was considered statistically significant. Results. When comparing normal weight and obese subjects, a significant increase in sRaw and a significant reduction in specific airway conductance (sGaw) were observed in obese subjects. In addition, an adequate and significant correlation was observed between sRaw and fat percentage. Conclusions. Obese subjects showed an increased sRaw and a reduced sGaw.

The impact of obesity on specific airway resistance and conductance among schoolchildren. / Influencia de la obesidad sobre la resistencia y conductancia específica de la vía aérea en niños escolares.

INTRODUCTION: Child and adolescent obesity is an epidemiological problem in developing countries. Its prevalence among preschoolers and schoolchildren is over 30%. It has been associated with a wide range of health complications, including rapid loss of lung function leading to changes in physiology and ventilatory mechanics. The objective of this study was to analyze the association between obesity and the increase in specific airway resistance (sRaw) in a sample of obese children and adolescents from the district of Talca. MATERIAL AND METHOD: In a sample of 36 subjects with an average age of 9.38 ± 1.99 years, divided into 2 groups (normal weight and obese), the tricipital, subscapular, and abdominal skinfolds and lung volumes were measured. For the statistical analysis, data normality was determined and then the Student's t test or the Mann-Whitney U test and Pearson's or Spearman's correlations were used, as applicable. A value of p < 0.05 was considered statistically significant. RESULTS: When comparing normal weight and obese subjects, a significant increase in sRaw and a significant reduction in specific airway conductance (sGaw) were observed in obese subjects. In addition, an adequate and significant correlation was observed between sRaw and fat percentage. CONCLUSIONS: Obese subjects showed an increased sRaw and a reduced sGaw.

INTRODUCCIÓN: La obesidad infantojuvenil es un problema epidemiológico en los países en vías de desarrollo. Su prevalencia entre los niños en edad preescolar y escolar supera el 30%. Esta se asocia a una amplia variedad de complicaciones de salud, entre ellas, una acelerada pérdida de la función pulmonar, que provoca cambios en la fisiología y mecánica ventilatoria. El objetivo de este estudio fue estudiar la asociación entre obesidad y aumento de la resistencia específica de las vías aéreas (specific resistance airway; sRaw, por sus siglas en inglés) en una muestra infantojuvenil obesa de la comuna de Talca. MATERIAL Y MÉTODO: En una muestra de 36 sujetos con un promedio de edad de 9,38 ± 1,99 años, dividida en dos grupos, peso normal y obesos, se midieron los pliegues tricipital, subescapular, abdominal y volúmenes pulmonares. Para el análisis estadístico, se determinó la normalidad de los datos y, posteriormente, se utilizaron los test t de Student o U de Mann-Whitney y Pearson o Spearman según correspondiera. Se consideró un nivel de significancia estadística de p < 0,05. RESULTADOS: Al comparar sujetos de peso normal con obesos, se observó un aumento significativo de la sRaw y una disminución significativa de la conductancia específica de la vía aérea en sujetos obesos. Además, se observó una correlación buena y significativa entre sRaw y porcentaje de grasa. CONCLUSIONES: Los sujetos obesos mostraron un aumento de la sRaw y disminución de la conductancia específica de la vía aérea.

Associations between infant fungal and bacterial dysbiosis and childhood atopic wheeze in a nonindustrialized setting.

BACKGROUND: Asthma is the most prevalent chronic disease of childhood. Recently, we identified a critical window early in the life of both mice and Canadian infants during which gut microbial changes (dysbiosis) affect asthma development. Given geographic differences in human gut microbiota worldwide, we studied the effects of gut microbial dysbiosis on atopic wheeze in a population living in a distinct developing world environment. OBJECTIVE: We sought to determine whether microbial alterations in early infancy are associated with the development of atopic wheeze in a nonindustrialized setting. METHODS: We conducted a case-control study nested within a birth cohort from rural Ecuador in which we identified 27 children with atopic wheeze and 70 healthy control subjects at 5 years of age. We analyzed bacterial and eukaryotic gut microbiota in stool samples collected at 3 months of age using 16S and 18S sequencing. Bacterial metagenomes were predicted from 16S rRNA data by using Phylogenetic Investigation of Communities by Reconstruction of Unobserved States and categorized by function with Kyoto Encyclopedia of Genes and Genomes ontology. Concentrations of fecal short-chain fatty acids were determined by using gas chromatography. RESULTS: As previously observed in Canadian infants, microbial dysbiosis at 3 months of age was associated with later development of atopic wheeze. However, the dysbiosis in Ecuadorian babies involved different bacterial taxa, was more pronounced, and also involved several fungal taxa. Predicted metagenomic analysis emphasized significant dysbiosis-associated differences in genes involved in carbohydrate and taurine metabolism. Levels of the fecal short-chain fatty acids acetate and caproate were reduced and increased, respectively, in the 3-month stool samples of children who went on to have atopic wheeze. CONCLUSIONS: Our findings support the importance of fungal and bacterial microbiota during the first 100 days of life on the development of atopic wheeze and provide additional support for considering modulation of the gut microbiome as a primary asthma prevention strategy.

Estudio Epidemiológico: Actividad Médica del Sistema de Salud de la Seguridad Social del Ecuador, 2013 / Epidemiological Study: Medical Activity of the Social Security Health System of Ecuador

INTRODUCCION: En la actualidad se considera al tratamiento quirúrgico como la primera línea de intervención en meningiomas, el objetivo de esta investigación es describir los resultados y las estrategias actuales en el tratamiento quirúrgico de los meningiomas, que se realizan en el Hospital Santa Inés de Cuenca-Ecuador. METODO: Es un estudio descriptivo sobre el tratamiento quirúrgico de los meningiomas, haciendo énfasis en el tipo de abordaje empleado en el Hospital Santa Inés. Se describen las diferentes localizaciones anatómicas y situaciones fisiológicas específicas de pacientes con meningiomas. RESULTADOS: Se incluyeron 31 pacientes, 11 hombres y 20 mujeres. La edad al momento de la cirugía fue de 13 a 76 años. La localización más frecuente fue la convexidad y parasagital. El 6.45 % de los tumores se reportaron como atípicos. Se logró exéresis Simpson I y II en el 80.6 % de los pacientes. Hubo tres recurrencias, dos de ellas asociadas a la histopatología. No hubo mortalidad operatoria. CONCLUSIONES: La cirugía sigue siendo la primera opción de tratamiento, con resultados mejorados con las técnicas microquirúrgicas actuales y constituye un reto, primero por lograr la exéresis completa del tumor y luego por preservar la función neurológica.(au)

BACKGROUD: At present the surgical treatment is considered as the first line in meningiomas, the aim of this study is to describe the outcomes and actual strategies in the surgical treatment of meningiomas treated at the Santa Ines Hospital in Cuenca-Ecuador. METHOD: It is a descriptive study on the surgical treatment of meningiomas, emphasizing the type of approach used in the Hospital Santa Inés. The different anatomical locations and specific physiological situations of patients with meningiomas are described. RESULTS: We included 31 patients, 11 men and 20 women. The age at the time of surgery was the between 13 to 76 years. The most frequent location was convexity and parasagittal. 6.45 % of the tumors were reported as atypical. Simpson I and II excision was achieved in 80.6 % of the patients. There were three recurrences, two associated with histopathology. There was no operative mortality. CONCLUSIONS: The surgery still is the first option of treatment, with better outcome due at the actual microsurgery techniques. The surgery is a challenge, at first achieve complete excision of the tumor and then to preserve the neurological function.(au)

Development of a taxonomy for pharmaceutical interventions in HIV+ patients based on the CMO model / Desarrollo de una taxonomía de las intervenciones farmacéuticas en pacientes VIH+ basados en el modelo CMO

Objective: To agree on a proposal for pharmaceutical interventions and establish their classification taxonomy according to the CMO-Pharmaceutical Care Model (Capacity-Motivation-Opportunity). Method: A study conducted between March and May, 2016. Two phases of development were defined. A literature review was initially conducted. Then, the DELPHI-Rand-UCLA methodology was used in order to reach a consensus about those interventions selected, and to define the taxonomy. Fifteen (15) experts, specialists in Pharmaceutical Care for HIV+ patients, were selected. This selection was explicitly conducted, following a protocol in order to avoid any bias. An initial proposal was developed according to the interventions extracted from Phase 1. These were tentatively classified according to the CMO Model, in a category based on their design and utility. Three issues were raised from the initial question: Do you agree with the proposed classification? If not, there was an option to re-categorize. Additionally, they were asked about the importance, priority and impact to achieve pharmacotherapeutic objectives that they would assign to it. Interventions were classified according to the degree of agreement. Once a consensus was reached, the final taxonomy was established. Results: Eighteen (18) articles were finally considered. The initial proposal included 20 pharmaceutical interventions with the following classification: seven in Capacity, eight in Motivation, and five in Opportunity. Those interventions considered to have greater importance and priority were: Review and Validation, Safety, and Adherence. The interventions with the greatest impact were: Review and Validation, Coordination, Adherence, and Motivation. On the other hand, the lowest scores for importance were for: Planning and Social Coordination; and in terms of impact: Social Coordination. Conclusions: The taxonomy reached by consensus will allow to classify pharmaceutical interventions with the new model, and therefore to conduct an improved research and patient car (AU)

Objetivo: Consensuar una propuesta de intervenciones farmacéuticas y llevar a cabo su taxonomía de clasificación según el modelo de Atención Farmacéutica-CMO (Capacidad-Motivación-Oportunidad). Método: Estudio realizado entre marzo-mayo de 2016. Se definieron dos fases de desarrollo. Inicialmente, se realizó una revisión bibliográfica. A continuación, para consensuar las intervenciones seleccionadas y definir la taxonomía se utilizó metodología DELPHI-Rand-UCLA. Se seleccionaron 15 expertos, especialistas en Atención Farmacéutica al paciente VIH+. La selección se realizó explícitamente, siguiendo un protocolo para evitar sesgos. Se elaboró, inicialmente, una propuesta a partir de las intervenciones extraídas de la fase-1. Se clasificaron tentativamente según el Modelo-CMO en una categoría según su diseño y utilidad. Se plantearon tres preguntas a partir de la cuestión inicial: ¿Está de acuerdo con la clasificación propuesta? En caso negativo, se daba opción de recategorizar. Adicionalmente, se planteó qué importancia, prioridad e impacto en la consecución de objetivos farmacoterapéuticos le daría. Las intervenciones se clasificaron en función del grado de acuerdo. Una vez consensuadas, se realizó la taxonomía definitiva. Resultados: Se consideraron finalmente 18 artículos. La propuesta inicial incluyó 20 intervenciones farmacéuticas clasificadas siete en Capacidad, ocho en Motivación y cinco en Oportunidad. Las intervenciones consideradas de mayor importancia y prioridad fueron: revisión y validación, seguridad y adherencia. Las de mayor impacto fueron: revisión y validación, coordinación, adherencia y motivación. Por contra, las de menor puntuación en importancia fueron: planificación y coordinación social y, en impacto, coordinación social. Conclusiones: La taxonomía consensuada permitirá clasificar las intervenciones farmacéuticas realizadas con el nuevo modelo y, así, profundizar en la investigación y la mejora asistencial (AU)