On the mechanism of visible-light sensitized photosulfoxidation of toluidine blue O.

We report on the formation of toluidine blue O (TBO) sulfoxide by a self-sensitized photooxidation of TBO. Here, the photosulfoxidation process was studied by mass spectrometry (MS) and discussed in the context of photodemethylation processes which both contribute to TBO consumption over time. Analysis of solvent effects with D2O, H2O, and CH3CN along with product yields and MS fragmentation patterns provided mechanistic insight into TBO sulfoxide's formation. The formation of TBO sulfoxide is minor and detectable up to 12% after irradiation of 3 h. The photosulfoxidation process is dependent on oxygen wherein instead of a type II (singlet oxygen, 1O2) reaction, a type I reaction involving TBO to reach the TBO sulfoxide is consistent with the results. Density functional theory results point to the formation of the TBO sulfoxide by the oxidation of TBO via transiently formed peroxyl radical or thiadioxirane intermediates. We discover that the TBO photosulfoxidation arises competitively with TBO photodemethylation with the latter leading to formaldehyde formation.

Frecuencia de dientes humanos extraídos utilizados en el proceso educativo en las Facultades de Odontología del Paraguay en el año 2019 / Frequency of extracted human teeth used in the educational process in the Schools of Dentistry of Paraguay in the year 2019

El uso de dientes humanos como material didáctico para la enseñanza odontológica siempre ha sido fundamental, por lo que existe una gran demanda de estos para la formación del estudiante de odontología. El objetivo del trabajo fue determinar la cantidad de piezas dentarias utilizadas en el proceso de enseñanza/aprendizaje en las facultades de odontología del Paraguay en el año 2019. Se realizó un estudio observacional descriptivo de corte transversal, mediante un cuestionario semiestructurado enviado por correo electrónico a las Instituciones de Educación Superior del Paraguay (IES) del sector público y privado que poseen carreras de odontología habilitadas por el CONES. Se obtuvo una tasa de respuesta del 77,78% (n= 14). El 86% de las IES (n=12) mencionó utilizar dientes humanos extraídos para la investigación y el 100% los utilizó para la enseñanza preclínica de grado. En el año 2019 se utilizaron un total de 11.211 dientes para la enseñanza preclínica de grado. Se obtuvo que entre todas las IES, la cátedra que con mayor frecuencia utilizó dientes fue endodoncia del tercer curso. Los dientes humanos extraídos son solicitados para la enseñanza de grado en la totalidad de las IES del Paraguay que fueron encuestadas y es elevado el número de dientes que fueron utilizados. Este trabajo permitió dimensionar el uso de dientes humanos extraídos en la formación del alumno de odontología y demostrar la necesidad de establecer mecanismos para su obtención de forma ética y legal.

The use of human teeth as didactic material for dental education has always been fundamental, which is why there is a great demand for these for the training of dental students. The objective of the work was to determine the number of dental pieces used in the teaching/learning process in the dentistry schools of Paraguay in the year 2019. A cross-sectional descriptive observational study was carried out, through a semi- structured questionnaire sent by email to Higher Education Institutions of Paraguay from the public and private sectors that have dental careers authorized by CONES.: A response rate of 77.78% (n = 14) was obtained. 86% of HEIs (n=12) mentioned using extracted human teeth for research and 100% used them for undergraduate preclinical teaching. In 2019, a total of 11,211 teeth were used for undergraduate preclinical teaching. It was obtained that among all HEIs, the departments that most frequently used teeth were endodontics in the third year. Extracted human teeth are requested for undergraduate education in all the HEIs in Paraguay that were surveyed, and the number of teeth that were used is high. This work allowed dimensioning the use of extracted human teeth in the training of dentistry students and demonstrating the need to establish mechanisms to obtain them ethically and legally.

SARS-CoV-2 Infection among School Population of One Developing Country. Do School Closures Protect Students and Teachers against SARS-CoV-2 Infection?

Evidence about the effectiveness of school closures as a measure to control the spread of COVID-19 is controversial. We posit that schools are not an important source of transmission; thus, we analyzed two surveillance methods: a web-based questionnaire and a telephone survey that monitored the impact of the pandemic due to COVID-19 cases in Bogotá, Colombia. We estimated the cumulative incidences for Acute Respiratory Infection (ARI) and COVID-19 for each population group. Then, we assessed the differences using the cumulative incidence ratio (CIR) and 95% confidence intervals (CI95%). The ARI incidence among students was 20.1 times higher when estimated from the telephone survey than from the online questionnaire (CIR: 20.1; CI95% 17.11-23.53). Likewise, the ARI incidence among schoolteachers was 10 times higher in the telephone survey (CIR: 9.8; CI95% 8.3-11.5). the incidence of COVID-19 among schoolteachers was 4.3 times higher than among students in the online questionnarie (CIR: 4.3, CI95%: 3.8-5.0) and 2.1 times higher in the telephone survey (CIR = 2.1, CI95%: 1.8-2.6), and this behavior was also observed in the general population data. Both methods showed a capacity to detect COVID-19 transmission among students and schoolteachers, but the telephone survey estimates were probably closer to the real incidence rate.

Antidiabéticos orales y su interacción con medicamentos modificadores de enfermedad

RESUMEN Los antidiabéticos orales (ADO) en pacientes con diabetes mellitus 2 y con comorbilidades reumatológicas no han demostrado interacción relevante con fármacos modificadores de la enfermedad (DMARDs), se debe recordar que la toma de varios medicamentos eleva el riesgo de interacciones o efectos adversos sobre todo si estos tienen un metabolismo en el mismo órgano. El objetivo es dar a conocer que interacciones existen entre los ADO y los DMARDs, mediante la búsqueda de artículos de revisión, guías farmacológicas y estudios. El resultado más sobresaliente fue el hallazgo de un estudio que abarca el uso de un DPP-4 (inhibidor de la dipeptidil peptidasa-4) especificamente sitagliptina como efecto protector frente a la toxicidad producida por el metotrexato. En pacientes con enfermedades reumatológicas y que padecen de diabetes mellitus 2, el uso de la hidroxicloroquina se ha comprobado que logra disminuir los niveles de lípidos, pero no específicamente como interacción medicamentosa con algún ADO, es una propiedad innata de la hidroxicloroquina. Se encontró evidencia de que existe correlación de hipoglicemia en pacientes que toman fármacos secretagogos y sulfazalacina.

ABSTRACT Oral antidiabetics drugs (OADs) in patients with diabetes mellitus 2 and with rheumatic comorbidities have not demonstrated relevant interaction with disease-modifying drugs (DMARDs). It should be remembered that taking several medications increases the risk of interactions or adverse effects especially if these have their metabolism in the same organ. The objective is to make known what interactions exist between OADs and DMARDs, by searching for review articles, pharmacological guides and studies. The most outstanding result was the finding of a study that covers the use of a DPP-4 (dipeptidyl peptidase-4 inhibitor), specifically sitagliptin as a protective effect against the toxicity produced by methotrexate. In patients with rheumatic diseases who also suffer from diabetes mellitus 2, the use of hydroxychloroquine has been shown to reduce lipid levels, but not specifically as a drug interaction with any OADs, it is an innate property of hydroxychloroquine. Evidence was found that there is a correlation of hypoglycemia in patients taking secretagogue drugs and sulfasalazine.

Hiponatremia asociada a hipopituitarismo en síndrome de silla turca vacía

RESUMEN Paciente femenino de 53 años de edad, que ingreso por cuadro clínico de 10 días de evolución caracterizado por mialgias y edema en extremidades inferiores. Al examen físico: facie abotagada, piel seca, cabello fino, disminución del vello axilar y púbico. En laboratorio se evidencia elevación de enzimas musculares (mioglobina 3000 U/L, CPK 2876 U/L), alteración del Na sérico 112 mEq/L, perfil tiroideo alterado (TSH normal a baja 1,14 UI/mL y FT4 baja 0,08 UI/ml), cortisol AM de 7,2 mcg/dL. Se solicito resonancia magnética con protocolo de silla turca se observa; hipófisis disminuida de tamaño en todos sus diámetros que confirma el hallazgo de un síndrome de silla turca parcialmente vacía. La hiponatremia asociada a hipopituitarismo es poco común.

ABSTRACT A 53-year-old female patient was admitted by a clinical case of 10 days of evolution characterized by myalgia and edema in the lower extremities. On physical examination: facial swelling, dry skin, fine hair, decreased axillary and pubic hair. In the laboratory there is evidence of elevation of muscle enzymes (myoglobin 3000 U/L, CPK 2876 U/L), alteration of serum Na 112 mEq/L, altered thyroid profile (normal to low TSH 1.14 IU/mL and FT4 low 0.08 IU/ml), AM cortisol 7.2 mcg/dL. Magnetic resonance imaging is requested with sella Turcica protocol. It is observed a decreased pituitary gland in all its diameters confirming the finding of a partially empty sella syndrome. Hyponatremia associated with hypopituitarism is uncommon.

Síndrome De Encefalopatía Posterior Reversible De Etiología Atípica / Posterior Reversible Encephalopathy Síndrome Of Atypical Etiology

Resumen El síndrome de encefalopatía posterior reversible, es un síndrome clínico-radiológico, caracterizado por imágenes compatibles con edema vasogénico, cuya fisiopatología no está esclarecida por completo. Existen múltiples causas descritas de este síndrome, principalmente hipertensión arterial severa, insuficiencia renal, sepsis, preeclampsia o eclampsia, terapia inmunosupresora, entre otras. Presentamos a continuación el caso de un paciente de 38 años, postrasplante renal en tratamiento con micofenolato y prednisona, con falla renal del trasplante y anemia crónica, hospitalizado por sepsis de foco urinario más tuberculosis ganglionar, quien tras recibir un concentrado de glóbulos rojos presenta convulsiones tónico clónicas, elevación de Hb de 3.1 g/dl e imágenes compatibles con edema vasogénico y resolución casi completa de las mismas a los 16 días.

Abstract Posterior reversible encephalopathy syndrome is a clinical-radiological syndrome, characterized by images compatible with vasogenic edema, whose pathophysiology is not fully clarified. There are multiple described causes of this syndrome, mainly severe arterial hypertension, renal insufficiency, sepsis, preeclampsia or eclampsia, immunosuppressive therapy and others. We report a case of a 38-year-old man, renal post-transplant in treatment with mycophenolate and prednisone, with renal failure of the transplant and chronic anemia, hospitalized by urinary focus sepsis plus lymph node tuberculosis, who after receiving 1 concentrate of red blood cells presents seizures, Hb elevation of 3.1 g/dl and images compatible with vasogenic edema and almost complete resolution of them at 16 days.

Initial Public Health Laboratory Response After Hurricane Maria - Puerto Rico, 2017.

Hurricane Maria made landfall in Puerto Rico on September 20, 2017, causing major damage to infrastructure and severely limiting access to potable water, electric power, transportation, and communications. Public services that were affected included operations of the Puerto Rico Department of Health (PRDOH), which provides critical laboratory testing and surveillance for diseases and other health hazards. PRDOH requested assistance from CDC for the restoration of laboratory infrastructure, surveillance capacity, and diagnostic testing for selected priority diseases, including influenza, rabies, leptospirosis, salmonellosis, and tuberculosis. PRDOH, CDC, and the Association of Public Health Laboratories (APHL) collaborated to conduct rapid needs assessments and, with assistance from the CDC Foundation, implement a temporary transport system for shipping samples from Puerto Rico to the continental United States for surveillance and diagnostic and confirmatory testing. This report describes the initial laboratory emergency response and engagement efforts among federal, state, and nongovernmental partners to reestablish public health laboratory services severely affected by Hurricane Maria. The implementation of a sample transport system allowed Puerto Rico to reinitiate priority infectious disease surveillance and laboratory testing for patient and public health interventions, while awaiting the rebuilding and reinstatement of PRDOH laboratory services.

Type 2 diabetes, depressive symptoms and disability over a 15-year follow-up period in older Mexican Americans living in the southwestern United States.

AIMS: To evaluate how depression and diabetes severity impact disability progression among Mexican Americans over a 15-year period. METHODS: We used seven waves of the Hispanic Established Population for the Epidemiologic Study of the Elderly (H-EPESE). Primary disability outcomes included the Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) scales. Explanatory variables included time since diagnosis with diabetes (no type 2 diabetes, 1-10, 11-20, 21+), an indicator of disease severity, and depression. Longitudinal generalized estimating equation models were used to estimate the relationship between time since diabetes diagnosis, depressive symptoms and ADL and IADL disability progression over a 15-year time period. RESULTS: Years since diabetes diagnosis was associated with more rapid ADL and IADL disability progression compared to those without type 2 diabetes. Depression accelerated the disabling process in participants who were diagnosed with diabetes 11years or more years ago. CONCLUSIONS: Longer duration of diabetes and greater symptoms of depression increase vulnerability for disability among older Mexican American adults.

An Investigation of the Relationship Between Alcohol Use and Major Depressive Disorder Across Hispanic National Groups.

BACKGROUND: There has been consistent epidemiological evidence of the association between drinking, alcohol dependence, and depression. However, most of the research has ignored potential diversity across Hispanic national subgroups. This study examines the prevalence of depression and explores its association with volume of drinking, age at first drink, binge drinking, and alcohol dependence across Mexican American, Puerto Rican, Cuban, and South/Central American Hispanic national groups. METHODS: Data from more than 19,000 Hispanic adults were obtained from the 2010 to 2012 National Survey on Drug Use and Health. Survey logistic regression methods were used to test for differences in the relationship between major depressive disorder (MDD) and alcohol consumption across national groups. RESULTS: The prevalence of MDD varied significantly across Hispanic national groups (χ(2)  = 67.06, p < 0.001). Puerto Ricans (14%) and Mexican Americans (9%) were most likely to have MDD. Mexican Americans had the highest prevalence of alcohol dependence, volume of consumption, and youngest age at first drink compared to Puerto Ricans, Cuban Americans, and Central/South Americans. Multivariate results suggest that the odds of alcohol dependence were nearly 4 times greater among Hispanics with MDD compared to Hispanics who did not meet the criteria for MDD. Hispanic national origin did not modify the association between MDD and alcohol use. CONCLUSIONS: Although significant differences in the prevalence rates of MDD and alcohol-use measures emerged across Hispanic national groups, there was no evidence that the relationships between these measures were different across Hispanic national groups. Further research should investigate the root causes of these variable MDD prevalence rates to inform detection and intervention efforts targeted toward specific national groups.

Disentangling contributions of bar attendance, drinking, and other factors to elevated acute alcohol problems on the U.S.-Mexico border.

BACKGROUND: Levels of drinking are unusually elevated among young adults on the U.S.-Mexico border, and this elevation can be largely explained by young border residents' unusually high frequency of bar attendance. However, this explanation complicates interpretation of high alcohol problem rates that have also been observed in this group. Because bar environments can lower the threshold for many types of problems, the extent to which elevated alcohol problems among young border residents can be attributed to drinking per se-versus this common drinking context-is not clear. METHODS: Data were collected from multistage cluster samples of adult Mexican Americans on and off the U.S.-Mexico border (current drinker N = 1,351). After developing structural models of acute alcohol problems, estimates were subjected to path decompositions to disentangle the common and distinct contributions of drinking and bar attendance to problem disparities on and off the border. Additionally, models were estimated under varying degrees of adjustment to gauge the sensitivity of the results to sociodemographic, social-cognitive, and environmental sources of confounding. RESULTS: Consistent with previous findings for both drinking and other problem measures, acute alcohol problems were particularly elevated among young adults on the border. This elevation was entirely explained by a single common pathway involving bar attendance frequency and drinking. Bar attendance did not predict acute alcohol problems independently of drinking, and its effect was not moderated by border proximity or age. The common indirect effect and its component effects (of border youth on bar attendance, of bar attendance on drinking, and of drinking on problems) were surprisingly robust to adjustment for confounding in all parts of the model (e.g., fully adjusted indirect effect: b = 0.11, SE = 0.04, p < 0.01). CONCLUSIONS: Bar attendance and associated increases in drinking play a key, unique role in the high levels of acute alcohol problems among the border's young adult population that cannot be entirely explained by sociodemographic or social-cognitive characteristics of young border residents, by contextual effects of bars on problems, or by broader neighborhood factors. Bar attendance in particular may represent an early modifiable risk factor that can be targeted to reduce alcohol problem disparities in the region.

Biodiversity on the Rocks: Macrofauna Inhabiting Authigenic Carbonate at Costa Rica Methane Seeps.

Carbonate communities: The activity of anaerobic methane oxidizing microbes facilitates precipitation of vast quantities of authigenic carbonate at methane seeps. Here we demonstrate the significant role of carbonate rocks in promoting diversity by providing unique habitat and food resources for macrofaunal assemblages at seeps on the Costa Rica margin (400-1850 m). The attendant fauna is surprisingly similar to that in rocky intertidal shores, with numerous grazing gastropods (limpets and snails) as dominant taxa. However, the community feeds upon seep-associated microbes. Macrofaunal density, composition, and diversity on carbonates vary as a function of seepage activity, biogenic habitat and location. The macrofaunal community of carbonates at non-seeping (inactive) sites is strongly related to the hydrography (depth, temperature, O2) of overlying water, whereas the fauna at sites of active seepage is not. Densities are highest on active rocks from tubeworm bushes and mussel beds, particularly at the Mound 12 location (1000 m). Species diversity is higher on rocks exposed to active seepage, with multiple species of gastropods and polychaetes dominant, while crustaceans, cnidarians, and ophiuroids were better represented on rocks at inactive sites. Macro-infauna (larger than 0.3 mm) from tube cores taken in nearby seep sediments at comparable depths exhibited densities similar to those on carbonate rocks, but had lower diversity and different taxonomic composition. Seep sediments had higher densities of ampharetid, dorvilleid, hesionid, cirratulid and lacydoniid polychaetes, whereas carbonates had more gastropods, as well as syllid, chrysopetalid and polynoid polychaetes. Stable isotope signatures and metrics: The stable isotope signatures of carbonates were heterogeneous, as were the food sources and nutrition used by the animals. Carbonate δ13Cinorg values (mean = -26.98‰) ranged from -53.3‰ to +10.0‰, and were significantly heavier than carbonate δ13Corg (mean = -33.83‰), which ranged from -74.4‰ to -20.6‰. Invertebrates on carbonates had average δ13C (per rock) = -31.0‰ (range -18.5‰ to -46.5‰) and δ15N = 5.7‰ (range -4.5‰ to +13.4‰). Average δ13C values did not differ between active and inactive sites; carbonate fauna from both settings depend on chemosynthesis-based nutrition. Community metrics reflecting trophic diversity (SEAc, total Hull Area, ranges of δ13C and δ15N) and species packing (mean distance to centroid, nearest neighbor distance) also did not vary as a function of seepage activity or site. However, distinct isotopic signatures were observed among related, co-occurring species of gastropods and polychaetes, reflecting intense microbial resource partitioning. Overall, the substrate and nutritional heterogeneity introduced by authigenic seep carbonates act to promote diverse, uniquely adapted assemblages, even after seepage ceases. The macrofauna in these ecosystems remain largely overlooked in most surveys, but are major contributors to biodiversity of chemosynthetic ecosystems and the deep sea in general.

An assessment of individual-level factors associated with alcohol treatment utilization among Mexican Americans.

The purpose of this study is to identify enabling factors for treatment utilization for alcohol-related problems, and to evaluate how enabling factors vary by need for treatment, among two samples of Mexican American adults. These two distinct samples included 2,595 current and former drinkers (one sample included 787 U.S./Mexico border residents; the other sample included 740 Mexican Americans living in U.S. cities not proximal to the border). Need for treatment (alcohol disorder severity) and (male) gender were the primary correlates of treatment utilization; and there was no moderation in the enabling factors by need for treatment as "enablers" of utilization. Further theoretical and empirical research is necessary to determine which mechanisms are driving disparities in treatment utilization across racial/ethnic groups generally, and Hispanic national groups specifically.

Myocardial dysfunction in pediatric septic shock.

OBJECTIVE: To evaluate the prevalence and significance of myocardial dysfunction in children with septic shock. STUDY DESIGN: Thirty patients with septic shock were evaluated by transthoracic echocardiography within 24 hours of admission to a pediatric critical care unit. Transthoracic echocardiography evaluation included left ventricular (LV) size and function, mitral valve inflow velocities in early and late diastole, mitral valve annular velocities in systole and early and late diastole, and LV myocardial performance index. LV systolic dysfunction was defined as an ejection fraction or shortening fraction z-score <-2, and LV diastolic dysfunction was defined as a mitral valve inflow velocity/annular velocity in early diastole ratio z-score >2. Secondary outcomes included troponin I concentration, acute kidney injury, and 28-day mechanical ventilation-free duration. RESULTS: Mortality for the 30 patients (mean age, 9.5 ± 7 years) was 7%. The prevalence of LV systolic and/or diastolic dysfunction was 53% (16 of 30). Eleven patients (37%) had systolic dysfunction, 10 (33%) had diastolic dysfunction, and 5 (17%) had both. Systolic and/or diastolic dysfunction was significantly associated with troponin I level (P = .007) and acute kidney injury (P = .02), but not with ventilation-free duration (P = .12). Kaplan-Meier analyses for pediatric critical care unit and hospital length of stay identified no differences between patients with and those without myocardial dysfunction. CONCLUSION: Myocardial dysfunction occurs frequently in children with septic shock but might not affect hospital length of stay.

Evidencia del uso de plantas medicinales en infecciones oculares / Evidence of the use of medicinal plants in eye infections

Los productos a base de plantas medicinales se pueden considerar como medicamentos, debido a sus efectos terapéuticos y reacciones adversas. La evidencia científica muestra actividad antiséptica, anti fúngica, reepitelizante, cicatrizante y anti-inflamatoria, que hace que las plantas posean efectos terapéuticos dependiendo su dosificación frente a diversas patologías oculares como conjuntivitis, ojo seco, dacriocistitis, blefaritis, demódex o enfermedades degenerativas. Por esta razón se presenta mediante una herramienta interactiva, las propiedades antimicrobianas en patología ocular, de las plantas medicinales. Objetivo: Caracterizar la evidencia científica del uso de plantas medicinales a nivel ocular a través de un recurso innovador e interactivo. Materiales y métodos: A través de las bases de datos Medline, Science Direct, Pubmed, ProQuest, E-libro, Embase. Se recopiló información asociada al uso de plantas medicinales a nivel general y ocular mediante los términos de búsqueda "antimicrobial activity medicinal plants ocular"," antimicrobial activity medicinal plants eye journal"," review antibacterial effects medicinal plants ocular infection multicentre research"," plantas medicinales a nivel ocular", "etnobotánica", "fitoterapia ocular" "medicinal plants and conjunctivitis", "medicinal plants and blepharitis", "medicinal plants and pterigion" La información se filtró de acuerdo con las fuentes de búsqueda, de libros, webs y artículos de los últimos quince años. Se recopiló información de la historia de la medicina natural, historia de las plantas medicinales, evidencia científica general y ocular de cada una de las plantas, seguidamente se filtró la información de las plantas medicinales seleccionando las más usadas a nivel ocular, con el fin de que el recurso interactivo tenga evidencia clínica actualizada. Finalmente se reprodujo por medio de un recurso interactivo el cual contiene información necesaria para dar al lector un conocimiento amplio de las características de las plantas medicinales y de sus bondades curativas para el tratamiento de las enfermedades oculares del segmento anterior. Conclusiones: Las plantas medicinales con más evidencia científica son Aloe Vera, Eufrasia, Melaleuca, Sándalo y Ajo, quienes muestran eficacia en bacterias como Estafilococos Aureus, Enterococos Escherichia coli, Aspergillus flavus; en diversas patologías oculares como conjuntivitis, blefaritis, ojo seco, dacriocistitis y queratitis. (AU)

El peso del niño al nacer en relación con el estado nutricional de la madre / Relationship between newbor's weight and mother's nutritional state

Estudio prospectivo para determinar la relación entre el peso del niño al nacer y el estado nutricional materno. Se estudiaron 28 mujeres sanas con sus neonatos. En ellas se evaluó: índice de masa corporal, ganancia de peso, circunferencia de brazo izquierdo, hemoglobina, hematocrito; en ellos: peso, talla e índice ponderal según edad gestacional. Las madres resultaron 85,71 por ciento eutroficas, 7,14 por ciento obesas y 7,14 por ciento en riesgo de desnutrición. Los neonatos fueron 75 por ciento eutróficos y 14,28 por ciento delgados. El 60,71 por ciento de los niños eutróficos proviene de madres eutróficas. Se concluyó que la mayoría de las madres evaluadas son eutróficas, la minoría con alto riesgo de tener niños de bajo peso