Role of vulvovaginal candidiasis infection in infertility: systematic review and meta-analysis.

OBJECTIVE: To evaluate the relationship between fungal infection in the female genital tract and infertility. DATA SOURCES: A systematic review was carried out, and the search was conducted in Medline, Embase, Web of Science, Google Scholar, and Cochrane Library databases until August 2022. The search strategy used standardized keywords such as "candidiasis" and "infertility," combined with their respective synonyms. The search was limited to human studies, with no language restrictions. STUDY ELIGIBILITY CRITERIA: Primary articles that evaluated women of reproductive age with and without infertility and related to the presence or absence of candidiasis were included. STUDY APPRAISAL AND SYNTHESIS METHODS: For the analyses, the odds ratio association measure was used with a confidence interval of 95% using RevMan software (version 5.4). RESULTS: Eight studies, published between 1995 and 2021 in different countries around the world, were included in this systematic review. Two studies were excluded after sensitivity analysis. A total of 909 participants were included in the group of infertile women and 2363 women in the control group. The age of the evaluated women varied between 18 and 50 years. The random effect model was used and showed no significant difference when comparing candidiasis between fertile and infertile women (odds ratio: 1.44; 95% confidence interval 0.86, 2.41 p= 0.17). CONCLUSIONS: There was no association between candidiasis and female sterility.

Epidemiological characteristics of P. vivax asymptomatic infections in the Peruvian Amazon.

Introduction: Herein, we tested the hypothesis that Asymptomatic P. vivax (Pv) infected individuals (Asym) feature different epidemiological, clinical and biochemical characteristics, as well as hematological parameters, potentially predictive of clinical immunity in comparison to symptomatic Pv infected individuals (Sym). Methodology: Between 2018 - 2021, we conducted 11 population screenings (PS, Day 0 (D0)) in 13 different riverine communities around Iquitos city, in the Peruvian Amazon, to identify Pv Sym and Asym individuals. A group of these individuals agreed to participate in a nested case - control study to evaluate biochemical and hematological parameters. Pv Asym individuals did not present common malaria symptoms (fever, headache, and chills), had a positive/negative microscopy result, a positive qPCR result, reported no history of antimalarial treatment during the last month, and were followed-up weekly until Day 21 (D21). Control individuals, had a negative malaria microscopy and qPCR result, no history of antimalarial treatment or malaria infections during the last three years, and no history of comorbidities or chronic infections. Results: From the 2159 individuals screened during PS, data revealed a low but heterogeneous Pv prevalence across the communities (11.4%), where most infections were Asym (66.7%) and submicroscopic (82.9%). A total of 29 Asym, 49 Sym, and 30 control individuals participated in the nested case - control study (n=78). Ten of the individuals that were initially Asym at D0, experienced malaria symptoms during follow up and therefore, were included in the Sym group. 29 individuals remained Asym throughout all follow-ups. High levels of eosinophils were found in Asym individuals in comparison to Sym and controls. Conclusion: For the first-time, key epidemiological, hematological, and biochemical features are reported from Pv Asym infections from the Peruvian Amazon. These results should be considered for the design and reshaping of malaria control measures as the country moves toward malaria elimination.

In vitro colonic fermentation of red kidney beans depends on cotyledon cells integrity and microbiota adaptation.

In the present study we investigated the effect of cellular integrity on microbial utilization of proteins and carbohydrates by gut microbiota. Cotyledon cells from red kidney beans with different levels of structural integrity were fermented in-vitro by microbial communities previously adapted to the conditions of ascending, transverse and descending colon. The effect of bacterial adaptation to substrate was also assessed by using microbiota exposed to a diet rich in bean cells. Microscopy analyses indicate that cell integrity was maintained during fermentation. The amount of gas generated and the rate of total gas production was higher in broken cells compared to intact cells which suggest a faster and more extensive utilization of nutrients when cell wall is broken. A significantly higher butyric and propionic acid level was detected in broken cells at the end of the fermentation. Moreover, adapted bacterial communities were more efficient in fermenting bean cells where higher amounts of butyrate were produced in all colon regions independently of sample integrity. Bacterial communities of the distal colon appeared to be the most efficient in carbohydrate and protein fermentation as witnessed by the higher levels of gas, and short chain fatty acids. It was also found that cell integrity and adaptation to bean cells modulate the hierarchy of nutrient utilization, with non-starch polysaccharides preferred over starch and proteins by microbiota exposed to bean cells. Our results demonstrated that structural aspects of foods, such as cell integrity in plant tissues, may modulate nutrients utilization by gut microbiota.

A mechanistic model to study the effect of the cell wall on starch digestion in intact cotyledon cells.

The role of the plant matrix is recognized as the main factor restricting starch digestibility in beans. Several authors have provided insights about the mechanisms behind the reduced starch digestibility in plant matrices. In this study, by means of a mathematical model, we provide a mechanistic explanation of the role played by the cell wall. It was confirmed that starch entrapped within intact cells could only be hydrolysed after α-amylase diffusion through the cell wall. This process is limited by the pores naturally present in the cell wall and the adsorption of α-amylase to the cell wall surface. These factors restrict the concentration of α-amylase available within the cells. The model assumptions are valid under controlled laboratory conditions and were validated with in-vitro digestion data giving very accurate results. The proposed approach provides new information to understand the digestibility of starch, and possibly other macronutrients, in complex food matrices.

COVID-19 with and without pneumonia: clinical outcomes in the internal medicine ward / COVID-19 con y sin neumonía: resultados en la sala de medicina interna

Abstract The clinical features of COVID-19 differ substantially upon the presence (or absence) of viral pneumonia. The aim of this article was to describe the clinical characteristics of COVID-19 patients admitted to the Internal Medicine ward, as divided into those with and without pneumonia. This single-center prospective cohort study was conducted in a tertiary teaching public hospital in Buenos Aires City named Hospital General de Agudos Carlos G. Durand. Baseline data collection was performed within 48 hours of admission and patients were followed until discharge or in-hospital death. Epidemiological, clinical, laboratory, and radiological characteristics together with treatment data were obtained from the medical records. Of the 417 included, 243 (58.3%) had pneumonia. Median age was 43 years (IQR:32-57) and 222 (53.2%) were female. The overall crude case-fatality rate was 3.8%. None of the COVID-19 patients without pneumonia developed critical disease, required invasive mechanical ventilation nor died during hospitalization. However, 7 (4%) developed severe disease during follow-up. Among patients with COVID-19 pneumonia, in-hospital mortality rate was 6.6%, severe disease developed in 81 (33.3%), critical disease in 23 (9.5%), and 22 (9.1%) were admitted to the intensive care unit. A largely good prognosis was observed among COVID-19 patients without pneumonia, still, even among this group, unfavorable clinical progression can develop and should be properly monitored. Critical illness among patients with COVID-19 pneumonia was frequent and observed rates from this cohort provide a sound characterization of COVID-19 clinical features in a major city from South America.

Resumen Las características clínicas del COVID-19 difieren sustancialmente según la presencia (o ausencia) de neumonía viral. El objetivo de este artículo fue describir las características clínicas de los pacientes con COVID-19 internados en el servicio de Clínica Médica, divididos en pacientes con y sin neumonía. Fue un estudio de cohorte prospectivo, con base en un único centro, realizado en un hospital público de la ciudad de Buenos Aires: Hospital General de Agudos Carlos G. Durand. La recolección basal de datos se realizó dentro de las 48 horas del ingreso y los pacientes fueron seguidos hasta el alta o la muerte hospitalaria. Las características epidemiológicas, clínicas, de laboratorio y radiológicas junto con los datos del tratamiento se obtuvieron de la historia clínica. De los 417 incluidos, 243 (58.3%) tenían neumonía. La mediana de edad fue de 43 años (RIC: 32-57) y 222 (53.2%) eran mujeres. La tasa global de letalidad fue del 3.8%. Ninguno de los pacientes con COVID-19 sin neumonía desarrolló enfermedad crítica, requirió ventilación mecánica invasiva ni falleció durante la hospitalización. Sin embargo, 7 (4%) desarrollaron enfermedad grave durante el seguimiento. Entre aquellos con neumonía COVID-19, la tasa de mortalidad hospitalaria fue del 6.6%, se desarrolló enfermedad grave en 81 (33.3%), enfermedad crítica en 23 (9.5%) y 22 (9.1%) fueron trasladados a la unidad de cuidados intensivos. Los pacientes con COVID-19 sin neumonía presentaron buen pronóstico; sin embargo, incluso en este grupo, se observaron algunos con progresión clínica desfavorable, por lo que se requirió seguimiento adecuado. En los pacientes con neumonía por COVID-19, el desarrollo de enfermedad crítica fue frecuente y las tasas observadas en esta cohorte proporcionan una caracterización sólida de las características clínicas de los pacientes con COVID-19 en una importante ciudad de América del Sur.

Estudio de cohorte prospectivo de pacientes con COVID-19 hospitalizados en servicio de clínica médica del Hospital Durand Protocolo de estudio / Prospective cohort study of patients with COVID-19 hospitalized in the Internal Medicine ward of Hospital Durand: study protocol

INTRODUCCIÓN: Conocer los predictores de mala evolución en pacientes con Enfermedad por Coronavirus 2019 (COVID-19) permite identificar de forma temprana a los pacientes con peor pronóstico, aportando mejores herramientas a la hora de tomar decisiones clínicas. Se presenta el protocolo de un estudio de cohorte cuyo objetivo principal es identificar factores de riesgo de infección severa, critica y mortalidad en pacientes con COVID-19 internados en el Servicio de Clínica Médica del Hospital Durand (Buenos Aires, Argentina). MÉTODOS: Estudio de cohorte prospectivo con base en un único centro. Se incluirá a todos los pacientes que ingresen al servicio de Clínica Médica con diagnóstico de COVID-19 durante el periodo de estudio. Se recolectarán las características epidemiológicas, clínicas, de laboratorio, radiológicas y los datos de tratamiento, al ingreso y al momento del alta o muerte hospitalaria. El evento final primario es la muerte en la internación; los eventos secundarios son el desarrollo de enfermedad grave y enfermedad crítica, la internación en unidad cerrada y el requerimiento de asistencia respiratoria mecánica.

COVID-19 with and without pneumonia: clinical outcomes in the internal medicine ward.

The clinical features of COVID-19 differ substantially upon the presence (or absence) of viral pneumonia. The aim of this article was to describe the clinical characteristics of COVID-19 patients admitted to the Internal Medicine ward, as divided into those with and without pneumonia. This single-center prospective cohort study was conducted in a tertiary teaching public hospital in Buenos Aires City named Hospital General de Agudos Carlos G. Durand. Baseline data collection was performed within 48 hours of admission and patients were followed until discharge or in-hospital death. Epidemiological, clinical, laboratory, and radiological characteristics together with treatment data were obtained from the medical records. Of the 417 included, 243 (58.3%) had pneumonia. Median age was 43 years (IQR:32-57) and 222 (53.2%) were female. The overall crude case-fatality rate was 3.8%. None of the COVID-19 patients without pneumonia developed critical disease, required invasive mechanical ventilation nor died during hospitalization. However, 7 (4%) developed severe disease during follow-up. Among patients with COVID-19 pneumonia, in-hospital mortality rate was 6.6%, severe disease developed in 81 (33.3%), critical disease in 23 (9.5%), and 22 (9.1%) were admitted to the intensive care unit. A largely good prognosis was observed among COVID-19 patients without pneumonia, still, even among this group, unfavorable clinical progression can develop and should be properly monitored. Critical illness among patients with COVID-19 pneumonia was frequent and observed rates from this cohort provide a sound characterization of COVID-19 clinical features in a major city from South America.

Las características clínicas del COVID-19 difieren sustancialmente según la presencia (o ausencia) de neumonía viral. El objetivo de este artículo fue describir las características clínicas de los pacientes con COVID-19 internados en el servicio de Clínica Médica, divididos en pacientes con y sin neumonía. Fue un estudio de cohorte prospectivo, con base en un único centro, realizado en un hospital público de la ciudad de Buenos Aires: Hospital General de Agudos Carlos G. Durand. La recolección basal de datos se realizó dentro de las 48 horas del ingreso y los pacientes fueron seguidos hasta el alta o la muerte hospitalaria. Las características epidemiológicas, clínicas, de laboratorio y radiológicas junto con los datos del tratamiento se obtuvieron de la historia clínica. De los 417 incluidos, 243 (58.3%) tenían neumonía. La mediana de edad fue de 43 años (RIC: 32-57) y 222 (53.2%) eran mujeres. La tasa global de letalidad fue del 3.8%. Ninguno de los pacientes con COVID-19 sin neumonía desarrolló enfermedad crítica, requirió ventilación mecánica invasiva ni falleció durante la hospitalización. Sin embargo, 7 (4%) desarrollaron enfermedad grave durante el seguimiento. Entre aquellos con neumonía COVID-19, la tasa de mortalidad hospitalaria fue del 6.6%, se desarrolló enfermedad grave en 81 (33.3%), enfermedad crítica en 23 (9.5%) y 22 (9.1%) fueron trasladados a la unidad de cuidados intensivos. Los pacientes con COVID-19 sin neumonía presentaron buen pronóstico; sin embargo, incluso en este grupo, se observaron algunos con progresión clínica desfavorable, por lo que se requirió seguimiento adecuado. En los pacientes con neumonía por COVID-19, el desarrollo de enfermedad crítica fue frecuente y las tasas observadas en esta cohorte proporcionan una caracterización sólida de las características clínicas de los pacientes con COVID-19 en una importante ciudad de América del Sur.

Promoting green infrastructure in Mexico's northern border: The Border Environment Cooperation Commission's experience and lessons learned.

This paper describes the application of a comprehensive strategic approach for integrating Green Infrastructure (GI) in urban planning in Mexican communities along the U.S-Mexico border as a means to mitigate the environmental, economic, and social impacts of inadequate stormwater management. Population growth and extended urban footprints in the region's cities have decreased rainfall infiltration and significantly increased runoff, carrying sediments and other pollutants into binational watersheds thus contributing to the pollution of aquatic habitats and potable water sources. As a strategy to mitigate these impacts, the Border Environment Cooperation Commission (BECC) developed a four year initiative with the long-term goal to support communities in building resiliency through the use of GI in public spaces such as parks, sidewalks, medians, and parking lots as a way to adapt to climate change, improve urban image, and strengthen native ecosystems. The Border Green Infrastructure Initiative was organized around training, strengthening municipal codes, developing pilot projects, restoring native vegetation, and the participation of residents, local government, and the private sector. The investment over the entire period was approximately USD$800,000. Outcomes were noteworthy. Approximately 900 professionals received various types of capacity building. Five cities and four Mexican border states were active participants in the program. Six pilot projects were implemented, three of which could capture a total volume of 4691 m3 of water in one year. In two sites the annual sediment collected was 656 m3. Finally, six technical tools were developed to assist communities in analysis and implementation. This approach represents a paradigm shift from the conventional management of stormwater through gray infrastructure and is intended to influence public policy at the local level, in a replicable and scalable way, resulting in more livable cities, improved water quality, and stronger binational environmental health.

The effect of cell wall encapsulation on macronutrients digestion: A case study in kidney beans.

Cotyledon cells in kidney beans naturally encapsulate starch and proteins limiting the access of digestive enzymes to their substrates. In this study, we investigated the effect of cell wall on bean protein digestibility and its relationship with starch digestion. Results showed that proteins contained in the cytoplasmic matrix influence the rate at which starch is digested in-vitro. Confocal laser scanning microscopy revealed that storage proteins in the cytoplasm act as a second encapsulation system preventing starch digestion. This microstructural organization only affected starch since no changes in protein digestion rate or extent were observed due to the presence of starch granules. Fourier transform infrared spectroscopy revealed that cellular entrapment limited protein denaturation induced by thermal treatments. High concentrations of a fraction resistant to digestion were found in proteins that were heated when entrapped within intact cotyledon cells, compared to those thermally treated as bean flour.

A closer look to cell structural barriers affecting starch digestibility in beans.

Isolated bean cells were used to understand the contribution of cell wall and cytoplasmic matrix on starch digestibility. Cotyledon cells were treated enzymatically and mechanically to reduce the level of cell intactness. SEM and chemical characterization revealed that enzymatic treatment modified cell wall thickness and porosity without altering the cytoplasmic matrix, whereas mechanical treatment completely disrupted cell structure. Decreasing cell intactness increased the rate but not the extent of starch digestion in-vitro. It was concluded that cell wall serves as a permeable barrier limiting the access of digestive enzymes. Cytoplasmic matrix, on the other hand, reduced further the accessibility of amylase to starch affecting its hydrolysis rate. In addition, it was proven that cell structural changes, if any, occurring during digestion had no effect on starch hydrolysis.

Microfluidic EDGE emulsification: the importance of interface interactions on droplet formation and pressure stability.

The fact that interactions of components with interfaces can influence processes is well-known; e.g. deposit accumulation on heat exchangers and membrane fouling lead to additional resistances against heat and mass transfer, respectively. In microfluidic emulsification, the situation is even more complex. Component accumulation at the liquid/liquid interface is necessary for emulsion stability, while undesired at the solid/liquid interface where it may change wettability. For successful emulsification both aspects need to be controlled, and that is investigated in this paper for o/w emulsification with microfluidic EDGE devices. These devices were characterised previously, and can be used to detect small wettability changes through e.g. the pressure stability of the device. We used various oil/emulsifier combinations (alkanes, vegetable oil, surfactants and proteins) and related droplet size and operational pressure stability to component interactions with the solid surface and liquid interface. Surfactants with a strong interaction with glass always favour emulsification, while surfactants that have week interactions with the surface can be replaced by vegetable oil that interacts strongly with glass, resulting in loss of emulsification. Our findings clearly show that an appropriate combination of construction material and emulsion components is needed to achieve successful emulsification in microfluidic EDGE devices.

Issues in biomedical research: what do Hispanics think?

OBJECTIVE: To examine barriers and facilitators of biomedical research participation among Hispanics in a rural community in Washington State. METHODS: Questionnaires addressed socio-demographics, health care access, and barriers and facilitators of participation in biomedical studies. This is a descriptive analysis of the findings. RESULTS: Barriers include the need to care for family members (82%), fear of having to pay for research treatments (74%), cultural beliefs (65%), lack of time (75%) and trust (71%), and the degree of hassle (73%). Facilitators include having a friend/relative with the disease being researched (80%) and monetary compensation (73%). CONCLUSION: Researchers should be mindful of these facilitators and barriers when recruiting for biomedical research studies.

Poor response to desmopressin acetate (DDAVP) in children with Hermansky-Pudlak syndrome.

BACKGROUND: Hermansky-Pudlak syndrome (HPS) is a common genetic disorder in Puerto Rico. In children with HPS, bleeding is the most disturbing and incapacitating problem. Desmopressin (1-deamino-8-D-arginine vasopressin, (DDAVP)) has been recommended in the management of bleeding disorders characterized by platelet dysfunction, such as HPS. METHODS: Nineteen pediatric Puerto Rican patients with HPS and prolonged bleeding time (BT) were tested for response to administration of DDAVP. RESULTS: Baseline BT was abnormal in 18 (95%) of the patients. The BT following DDAVP administration improved in two cases (11%): one from 7.2 to 5.6 min and the other from 8 to 6 min (Tables II and III). BT measurements remained very prolonged (>15 min) in 17 (89%) of the patients. Patients with the HPS 1 gene mutation had a statistically significant correlation with the poor response following DDAVP (P = 0.03). CONCLUSIONS: DDAVP seldom improves the BT of Puerto Rican children with HPS. Response to DDAVP should be determined individually and platelet transfusion should remain the treatment of choice for a major bleeding episode or surgical procedure.

Valor del ultrasonido en el diagnóstico del crecimiento intrauterino retardado (CIUR) / Value of the ultrasonic in the diagnosis of the slowed intra-uterine growth (CIUR)

Se realizó un estudio de tipo caso control en el servicio de Ginecobstetricia y Radiología del Hospital General Docente "Dr Agostinho Neto" de la provincia de Guantánamo, desde enero a diciembre de 1995, con el fin de demostrar el valor de algunos indicadores sonográficos en el diagnóstico del CIUR. Los estudiados fueron: diámetro biparietal (DBP), circunferencia abdominal (CA), relación circunferencia cefálica/circunferencia abdominal (CC/CA), relación longitud del fémur/circunferencia abdominal (LF/CA), índice de líquido amniótico (ILA), madurez placentaria (MP). Se estudiaron 30 embarazadas con diagnóstico clínico de CIUR (casos) y 60 embarazadas con una evolución normal de la biometría fetal (controles). La relación CC/CA fue el indicador que más estuvo asociado al diagnóstico de CIUR (RR=134,3), resultados obtenidos a través del análisis estadístico de la regresión logística multivariante con sus coeficientes logísticos. Otro indicdor con alta relación al diagnóstico del CIUR fue la circunferencia abdominal (CA)(RR=66,6). La eficacia diagnóstica y pronóstica arrojó un valor predictivo positivo (VP+=64,9 por ciento), valor predictivo negativo (VP-=100 por ciento), prevalencia 26,7 por ciento, sensibilidad 100 por ciento y especificidad de 80 por ciento. Se concluye que el ultrasonido tiene un gran valor en el diagnóstico de exclusión y confirmación del CIUR, y se recomienda continuar perfeccionando y utilizando este medio diagnóstico en nuestra provincia para el diagnóstico precoz de esta entidad obstétrica(AU)