Electrode Surface Area Impacts Measurement of High Frequency Oscillations in Human Intracranial EEG.

OBJECTIVE: High-frequency oscillations (HFOs) are a promising prognostic biomarker of surgical outcome in patients with epilepsy. Their rates of occurrence and morphology have been studied extensively using recordings from electrodes of various geometries. While electrode size is a potential confounding factor in HFO studies, it has largely been disregarded due to a lack of consistent evidence. Therefore, we designed an experiment to directly test the impact of electrode size on HFO measurement. METHODS: We first simulated HFO measurement using a lumped model of the electrode-tissue interaction. Then eight human subjects were each implanted with a high-density 8x8 grid of subdural electrodes. After implantation, the electrode sizes were altered using a technique recently developed by our group, enabling intracranial EEG recordings for three different electrode surface areas from a static brain location. HFOs were automatically detected in the data and their characteristics were calculated. RESULTS: The human subject measurements were consistent with the model. Specifically, HFO rate measured per area of tissue decreased significantly as electrode surface area increased. The smallest electrodes recorded more fast ripples than ripples. Amplitude of detected HFOs also decreased as electrode surface area increased, while duration and peak frequency were unaffected. CONCLUSION: These results suggest that HFO rates measured using electrodes of different surface areas cannot be compared directly. SIGNIFICANCE: This has significant implications for HFOs as a tool for surgical planning, particularly for individual patients implanted with electrodes of multiple sizes and comparisons of HFO rate made across patients and studies.

A phase I dose escalation and expansion trial of the next-generation oral SERD camizestrant in women with ER-positive, HER2-negative advanced breast cancer: SERENA-1 monotherapy results.

BACKGROUND: SERENA-1 (NCT03616587) is a phase I, multi-part, open-label study of camizestrant in pre- and post-menopausal women with estrogen receptor-positive (ER+), human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer. Parts A and B aim to determine the safety and tolerability of camizestrant monotherapy and define doses for clinical evaluation. PATIENTS AND METHODS: Women aged ≥18 years with metastatic or recurrent ER+, HER2- breast cancer, refractory (or intolerant) to therapy, were assigned 25 mg up to 450 mg once daily (QD; escalation) or 75, 150, or 300 mg QD (expansion). Safety and tolerability, antitumor efficacy, pharmacokinetics, and impact on mutations in the estrogen receptor gene (ESR1m) circulating tumor (ct)DNA levels were assessed. RESULTS: By 9 March 2021, 108 patients received camizestrant monotherapy at 25-450 mg doses. Of these, 93 (86.1%) experienced treatment-related adverse events (TRAEs), 82.4% of which were grade 1 or 2. The most common TRAEs were visual effects (56%), (sinus) bradycardia (44%), fatigue (26%), and nausea (15%). There were no TRAEs grade 3 or higher, or treatment-related serious adverse events at doses ≤150 mg. Median tmax was achieved ∼2-4 h post-dose at all doses investigated, with an estimated half-life of 20-23 h. Efficacy was observed at all doses investigated, including in patients with prior cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) and/or fulvestrant treatment, with and without baseline ESR1 mutations, and with visceral disease, including liver metastases. CONCLUSIONS: Camizestrant is a next-generation oral selective ER antagonist and degrader (SERD) and pure ER antagonist with a tolerable safety profile. The pharmacokinetics profile supports once-daily dosing, with evidence of pharmacodynamic and clinical efficacy in heavily pre-treated patients, regardless of ESR1m. This study established 75-, 150-, and 300-mg QD doses for phase II testing (SERENA-2, NCT04214288 and SERENA-3, NCT04588298).

Tumor glómico del septum nasal / Glomic tumor of the nasal septum

Presentamos el caso clínico de una mujer de 58 años que consulta por episodios de epis-taxis autolimitadas por fosa nasal derecha asociados a hipersensibilidad al manipular dicha fosa nasal. A la exploración se evidenció en el septum nasal una lesión mucosa nodular, de consistencia dura y aspecto violáceo. Se llevó a cabo exéresis de la misma por vía endonasal, con resultado histopatológico de tumor glómico (TG) del septum nasal. El TG es una neoplasia benigna perivascular, derivada de las células musculares lisas presentes en el cuerpo glómico; estructura con función termorreguladora, formada por un shunt entre arteriolas y vénulas, sin presencia de red capilar. Los cuerpos glómicos están presentes, mayoritariamente, en extremidades (lecho ungueal). Los tumores glómicos son, verdaderamente, excepcionales en el área ORL, existiendo sólo una treintena de casos publicados hasta la fecha a nivel nasosinusal. La mayoría de casos se presentan entre la 5ᵃ y 6ᵃ década de la vida y más, frecuentemente, en mujeres. Plantea diagnóstico diferencial, fundamentalmente, con dos entidades: el paraganglioma (con el que no debe ser confundido desde el punto de vista terminológico ni histológico), y con el tumor fibroso solitario (antiguo hemangiopericitoma). El comportamiento es benigno y el tratamiento es la cirugía

We present the clinical case of a 58-year-old woman who consulted for episodes of self-limited epistaxis in the right nostril associated with hypersensitivity to manipulation of this nostril. Examination revealed a nodular mucosal lesion in the nasal septum, with a hard consistency and purplish appearance. The lesion was excised endonasally, with histopatho-logical result of a glomus tumor (GT) of the nasal septum. The GT is a benign perivascular neoplasm, derived from smooth muscle cells present in the glomus body; structure with thermoregulatory function, formed by a shunt between arterioles and venules, without the presence of capillary network. Glomus bodies are mostly present in the extremities (nail bed). Glomus tumors are truly exceptional in the ENT area, with only about thirty cases published to date at the nasosinusal level. Most cases occur between the 5th and 6th decade of life and more frequently in women. It raises differential diagnosis fundamentally with two entities: paraganglioma (with which it should not be confused from the terminological or histological point of view) and with solitary fibrous tumor (former hemangiopericytoma). The behavior is benign and the treatment is surgery.

Complicaciones ORL severas por mononucleosis infecciosa en adolescentes sanos: 2 casos clínicos y revisión de la literatura / ENT severe complications of infectious mononucleosis in healthy adolescents: report of two cases and literature review

Resumen La mononucleosis infecciosa (MI) es un cuadro clínico generalmente benigno y autolimitado en la infancia y adolescencia debido a la primoinfección del virus de Epstein-Barr caracterizado por la triada de faringitis, fiebre y adenopatías. El riesgo de complicaciones aumenta con la edad y la inmunosupresión, siendo las complicaciones letales más frecuentes las asociadas a rotura esplénica, alteraciones neurológicas y obstrucción de la vía aérea por el aumento del tamaño amigdalar. Los abscesos cervicales asociados a MI son poco frecuentes, siendo mayoritariamente periamigdalinos e intraamigdalares. Presentamos dos casos quirúrgicos de abscesos cervicales profundos de gran tamaño con afectación retrofaríngea y parafaríngea en adolescentes sanos de corta edad (14 y 15 años), sin ningún tipo de inmunosupresión o factores de riesgo, uno de ellos asociado además, a una relevante hemorragia amigdalar espontanea, condición no descrita previamente en la literatura en relación a MI en un paciente tan joven.

Abstract Infectious mononucleosis (MI) is a generally benign and self-limited condition in childhood and adolescence due to the primary EBV infection characterized by the triad of pharyngitis, fever, and lymphadenopathies. The risk of complications increases with age and immunosuppression. The most frequent fatal complications are those associated with splenic rupture, neurological alterations, and airway obstruction due to increased tonsillar size. Cervical abscesses associated with MI are rare, being mostly peritonsillar and intra-tonsil. We present two surgical cases of big deep cervical abscesses with retropharyngeal and parapharyngeal involvement in healthy very young adolescents (14 and 15 years old), without any type of immunosuppression or risk factors, one of them associated with a clinically relevant spontaneous tonsillar bleeding, which had not been described in the literature associated with MI in such young patient.

Longitudinal Study after Sputnik V Vaccination Shows Durable SARS-CoV-2 Neutralizing Antibodies and Reduced Viral Variant Escape to Neutralization over Time.

Recent studies have shown a temporal increase in the neutralizing antibody potency and breadth to SARS-CoV-2 variants in coronavirus disease 2019 (COVID-19) convalescent individuals. Here, we examined longitudinal antibody responses and viral neutralizing capacity to the B.1 lineage virus (Wuhan related), to variants of concern (VOC; Alpha, Beta, Gamma, and Delta), and to a local variant of interest (VOI; Lambda) in volunteers receiving the Sputnik V vaccine in Argentina. Longitudinal serum samples (N = 536) collected from 118 volunteers obtained between January and October 2021 were used. The analysis indicates that while anti-spike IgG levels significantly wane over time, the neutralizing capacity for the Wuhan-related lineages of SARS-CoV-2 and VOC is maintained within 6 months of vaccination. In addition, an improved antibody cross-neutralizing ability for circulating variants of concern (Beta and Gamma) was observed over time postvaccination. The viral variants that displayed higher escape to neutralizing antibodies with respect to the original virus (Beta and Gamma variants) were the ones showing the largest increase in susceptibility to neutralization over time after vaccination. Our observations indicate that serum neutralizing antibodies are maintained for at least 6 months and show a reduction of VOC escape to neutralizing antibodies over time after vaccination. IMPORTANCE Vaccines have been produced in record time for SARS-CoV-2, offering the possibility of halting the global pandemic. However, inequalities in vaccine accessibility in different regions of the world create a need to increase international cooperation. Sputnik V is a recombinant adenovirus-based vaccine that has been widely used in Argentina and other developing countries, but limited information is available about its elicited immune responses. Here, we examined longitudinal antibody levels and viral neutralizing capacity elicited by Sputnik V vaccination. Using a cohort of 118 volunteers, we found that while anti-spike antibodies wane over time, the neutralizing capacity to viral variants of concern and local variants of interest is maintained within 4 months of vaccination. In addition, we observed an increased cross-neutralization activity over time for the Beta and Gamma variants. This study provides valuable information about the immune response generated by a vaccine platform used in many parts of the world.

RITS: a toolbox for assessing complex interventions via interrupted time series models.

BACKGROUND: Various interacting and interdependent components comprise complex interventions. These components create difficulty in assessing the true impact of interventions designed to improve patient-centered outcomes. Interrupted time series (ITS) designs borrow from case-crossover designs and serve as quasi-experimental methodology able to retrospectively assess the impact of an intervention while accounting for temporal correlation. While ITS designs are aptly situated for studying the impacts of large-scale public health policies, existing ITS software implement rigid ITS methodology that often assume the pre- and post-intervention phases are fully differentiated (by a known change-point or set of time points) and do not allow for changes in both the mean functions and correlation structure. RESULTS: This article describes the Robust Interrupted Time Series (RITS) toolbox, a stand-alone user-friendly application researchers can use to implement flexible ITS models that estimate the lagged effect of an intervention on an outcome, level and trend changes, and post-intervention changes in the correlation structure, for single and multiple ITS. The RITS toolbox incorporates a formal test for the existence of a change in the outcome and estimates a change-point over a set of possible change-points defined by the researcher. In settings with multiple ITS, RITS provides a global over-all units change-point and allows for unit-specific changes in the mean functions and correlation structures. CONCLUSIONS: The RITS toolbox is the first piece of software that allows researchers to use flexible ITS models that test for the existence of a change-point, estimate the change-point (if estimation is desired), and allow for changes in both the mean functions and correlation structures at the change point. RITS does not require any knowledge of a statistical (or otherwise) programming language, is freely available to the community, and may be downloaded and used on a local machine to ensure data protection.

Sputnik V vaccine elicits seroconversion and neutralizing capacity to SARS-CoV-2 after a single dose.

Massive vaccination offers great promise for halting the global COVID-19 pandemic. However, the limited supply and uneven vaccine distribution create an urgent need to optimize vaccination strategies. We evaluate SARS-CoV-2-specific antibody responses after Sputnik V vaccination of healthcare workers in Argentina, measuring IgG anti-spike titers and neutralizing capacity after one and two doses in a cohort of naive or previously infected volunteers. By 21 days after receiving the first dose of the vaccine, 94% of naive participants develop spike-specific IgG antibodies. A single Sputnik V dose elicits higher antibody levels and virus-neutralizing capacity in previously infected individuals than in naive ones receiving the full two-dose schedule. The high seroconversion rate after a single dose in naive participants suggests a benefit of delaying administration of the second dose to increase the number of people vaccinated. The data presented provide information for guiding public health decisions in light of the current global health emergency.

Do cone age and heating mode determine the opening of serotinous cones during wildfires? A new bench scale approach applied to Pinus halepensis Mill.

Serotiny is a well-known fire adaptive trait in some species, as the Mediterranean conifer Pinus halepensis. However, information about cone opening mechanisms during wildfires and consequences on post fire dispersal is scarce. In addition, standardized methods allowing a realistic simulation of heating modes at bench-scale are not available. In this study, we address for the first time the interacting effects of radiation, convection and direct flame on the opening and seed release of serotinous cones, following a novel repeatable methodology. Using a Mass Loss Calorimeter (MLC) device and a wide range of heat exposures (between 5 and 75 kW m-2) with or without ignition, we intended to simulate realistic cone heating during surface and crown fires in laboratory conditions. Additionally, we included the effect of contrasting serotinous cone ages interacting with heating mode and considering the random individual variation. The proposed methodology has shown a high potential to simulate the complex process of crown fires in relation to cone opening under controlled conditions, detecting a threshold of heat exposure (25-30 kW m-2) for cone opening. We confirmed that heating mode had a highly significant effect in cone opening, interacting with cone age, while cone age effect on its own was marginal. Particularly, ignition significantly increased the efficacy of cone opening and seed release. Moreover, young and old cones behave differently in seed release, both in surface and crown fire simulations. Implementing and adjusting this methodology in other species will allow more realistic and reliable quantitative comparisons than previously attained.

The week after running a marathon: Effects of running vs elliptical training vs resting on neuromuscular performance and muscle damage recovery.

Our aim was to compare the effects of two exercise modalities vs resting on the time course of neuromuscular performance and muscle damage recovery during the week after running a marathon. Sixty-four finishers from a road marathon completed the study (54 men and 10 women; 39 ± 4 years; 3 h 35 min ± 21 min). The day before the race, within 15 min after finishing the marathon and at 24, 48, 96, 144 and 192 h postrace, lactate dehydrogenase and creatine kinase were analysed. Participants also performed a squat jump (SJ) test before and after the marathon and at 48, 96 and 144 h postrace. On their arrival to the finish line, participants were randomized into one of the three intervention groups: running (RUN), elliptical training (ELIP) and resting recovery (REST). RUN and ELIP groups exercised continuously for 40 min at a moderate intensity (95-105% of the HR corresponding to the first ventilatory threshold) at 48, 96 and 144 h after the marathon. Neither 'Intervention' factor nor 'Intervention x Time' interaction effects were revealed for muscle damage blood markers (p > 0.05). On the other hand, RUN group evidenced an enhancement in SJ performance 96 h post-marathon as compared with REST group (108.29 ± 10.64 vs 100.58 ± 9.16%, p = 0.020, d = 0.80). Consequently, return to running at 48 h post-marathon does not seem to have a negative impact on muscle damage recovery up to eight days post-race and it could be recommended in order to speed up neuromuscular recovery.

It's a matter of time: the role of transcriptional regulation in the circadian clock-pathogen crosstalk in plants.

Most living organisms possess an internal timekeeping mechanism known as the circadian clock, which enhances fitness by synchronizing the internal timing of biological processes with diurnal and seasonal environmental changes. In plants, the pace of these biological rhythms relies on oscillations in the expression level of hundreds of genes tightly controlled by a group of core clock regulators and co-regulators that engage in transcriptional and translational feedback loops. In the last decade, the role of several core clock genes in the control of defense responses has been addressed, and a growing amount of evidence demonstrates that circadian regulation is relevant for plant immunity. A reciprocal connection between these pathways was also established following the observation that in Arabidopsis thaliana, as well as in crop species like tomato, plant-pathogen interactions trigger a reconfiguration of the circadian transcriptional network. In this review, we summarize the current knowledge regarding the interaction between the circadian clock and biotic stress responses at the transcriptional level, and discuss the relevance of this crosstalk in the plant-pathogen evolutionary arms race. A better understanding of these processes could aid in the development of genetic tools that improve traditional breeding practices, enhancing tolerance to plant diseases that threaten crop yield and food security all around the world.

Immediate and 24-h post-marathon cardiac troponin T is associated with relative exercise intensity.

PURPOSE: We aimed at exploring whether cardiopulmonary fitness, echocardiographic measures and relative exercise intensity were associated with high-sensitivity cardiac troponin T (hs-TNT) rise and normalization following a marathon. METHODS: Nighty-eight participants (83 men, 15 women; 38.72 ± 3.63 years) were subjected to echocardiographic assessment and a cardiopulmonary exercise test (CPET) before the race. hs-TNT was measured before, immediately after and at 24, 48, 96, 144 and 192 h post-race. Speed and mean heart rate (HR) during the race were relativized to CPET values: peak speed (%VVMAX), peak HR (HR%MAX), speed and HR at the second ventilatory threshold (HR%VT2 and %VVT2). RESULTS: Hs-TNT increased from pre- to post-race (5.74 ± 5.29 vs. 50.4 ± 57.04 ng/L; p < 0.001), seeing values above the Upper Reference Limit (URL) in 95% of the participants. At 24 h post-race, 39% of the runners still exceeded the URL (High hs-TNT group). hs-TNT rise was correlated with marathon speed %VVT2 (r = 0.22; p = 0.042), mean HR%VT2 (r = 0.30; p = 0.007), and mean HR%MAX (r = 0.32; p = 0.004). Moreover, the High hs-TNT group performed the marathon at a higher Speed %VVT2 (88.21 ± 6.53 vs. 83.49 ± 6.54%; p = 0.002) and Speed %VVMAX (72 ± 4.25 vs. 69.40 ± 5.53%; p = 0.009). hs-TNT showed no significant associations with cardiopulmonary fitness and echocardiographic measures, except for a slight correlation with left ventricular end systolic diameter (r = 0.26; p = 0.018). CONCLUSION: Post-race hs-TNT was above the URL in barely all runners. Magnitude of hs-TNT rise was correlated with exercise mean HR; whereas, its normalization kept relationship with marathon relative speed.

Estimating and forecasting COVID-19 attack rates and mortality

We describe a model for estimating past and current infections as well as future deaths due to the ongoing COVID-19 pandemic. The model does not use confirmed case numbers and is based instead on recorded numbers of deaths and on the age-specific population distribution. A regularized deconvolution technique is used to infer past infections from recorded deaths. Forecasting is based on a compartmental SIR-type model, combined with a probability distribution for the time from infection to death. The effect of non-pharmaceutical interventions (NPIs) is modelled empirically, based on recent trends in the death rate. The model can also be used to study counterfactual scenarios based on hypothetical NPI policies.

Bacterial Infection Disrupts Clock Gene Expression to Attenuate Immune Responses.

The circadian clock modulates immune responses in plants and animals; however, it is unclear how host-pathogen interactions affect the clock. Here we analyzed clock function in Arabidopsis thaliana mutants with defective immune responses and found that enhanced disease susceptibility 4 (eds4) displays alterations in several circadian rhythms. Mapping by sequencing revealed that EDS4 encodes the ortholog of NUCLEOPORIN 205, a core component of the inner ring of the nuclear pore complex (NPC). Consistent with the idea that the NPC specifically modulates clock function, we found a strong enrichment in core clock genes, as well as an increased nuclear to total mRNA accumulation, among genes that were differentially expressed in eds4 mutants. Interestingly, infection with Pseudomonas syringae in wild-type (WT) plants downregulated the expression of several morning core clock genes as early as 1 h post-infection, including all members of the NIGHT LIGHT-INDUCIBLE AND CLOCK-REGULATED (LNK) gene family, and this effect was attenuated in eds4. Furthermore, lnk mutants were more susceptible than the WT to P. syringae infection. These results indicate that bacterial infection, acting in part through the NPC, alters core clock gene expression and/or mRNA accumulation in a way that favors bacterial growth and disease susceptibility.

Assessing the age- and gender-dependence of the severity and case fatality rates of COVID-19 disease in Spain.

Background: The assessment of the severity and case fatality rates of coronavirus disease 2019 (COVID-19) and the determinants of its variation is essential for planning health resources and responding to the pandemic. The interpretation of case fatality rates (CFRs) remains a challenge due to different biases associated with surveillance and reporting. For example, rates may be affected by preferential ascertainment of severe cases and time delay from disease onset to death. Using data from Spain, we demonstrate how some of these biases may be corrected when estimating severity and case fatality rates by age group and gender, and identify issues that may affect the correct interpretation of the results. Methods: Crude CFRs are estimated by dividing the total number of deaths by the total number of confirmed cases. CFRs adjusted for preferential ascertainment of severe cases are obtained by assuming a uniform attack rate in all population groups, and using demography-adjusted under-ascertainment rates. CFRs adjusted for the delay between disease onset and death are estimated by using as denominator the number of cases that could have a clinical outcome by the time rates are calculated. A sensitivity analysis is carried out to compare CFRs obtained using different levels of ascertainment and different distributions for the time from disease onset to death. Results: COVID-19 outcomes are highly influenced by age and gender. Different assumptions yield different CFR values but in all scenarios CFRs are higher in old ages and males. Conclusions: The procedures used to obtain the CFR estimates require strong assumptions and although the interpretation of their magnitude should be treated with caution, the differences observed by age and gender are fundamental underpinnings to inform decision-making.

Inference on Long-Range Temporal Correlations in Human EEG Data.

Detrended Fluctuation Analysis (DFA) is a statistical estimation algorithm used to assess long-range temporal dependence in neural time series. The algorithm produces a single number, the DFA exponent, that reflects the strength of long-range temporal correlations in the data. No methods have been developed to generate confidence intervals for the DFA exponent for a single time series segment. Thus, we present a statistical measure of uncertainty for the DFA exponent in electroencephalographic (EEG) data via application of a moving-block bootstrap (MBB). We tested the effect of three data characteristics on the DFA exponent: (1) time series length, (2) the presence of artifacts, and (3) the presence of discontinuities. We found that signal lengths of ∼5 minutes produced stable measurements of the DFA exponent and that the presence of artifacts positively biased DFA exponent distributions. In comparison, the impact of discontinuities was small, even those associated with artifact removal. We show that it is possible to combine a moving block bootstrap with DFA to obtain an accurate estimate of the DFA exponent as well as its associated confidence intervals in both simulated data and human EEG data. We applied the proposed method to human EEG data to (1) calculate a time-varying estimate of long-range temporal dependence during a sleep-wake cycle of a healthy infant and (2) compare pre- and post-treatment EEG data within individual subjects with pediatric epilepsy. Our proposed method enables dynamic tracking of the DFA exponent across the entire recording period and permits within-subject comparisons, expanding the utility of the DFA algorithm by providing a measure of certainty and formal tests of statistical significance for the estimation of long-range temporal dependence in neural data.

Short-term effects of prescribed burning on litterfall biomass in mixed stands of Pinus nigra and Pinus pinaster and pure stands of Pinus nigra in the Cuenca Mountains (Central-Eastern Spain).

Fire severity, defined as the magnitude of fire effects in an ecosystem, is a key factor to consider in planning management strategies for protecting forests against fire. Although prescribed burning has been used as a fuel reduction tool in forest ecosystems, it is quite limited in the Mediterranean region. Furthermore, little is known about how tree crowns are affected by prescribed underburning aimed at reducing fire severity in conifer stands. As part of an ongoing study to assess the effects of prescribed burning on the tree canopy, litterfall is currently being monitored in a network of experimental plots located in mixed (Pinus nigra and Pinus pinaster) and pure (P. nigra) conifer stands in the Cuenca Mountains (Castilla La Mancha, Spain). A total of 12 study plots (30m×30m) were established in a completely randomized experimental design to determine the effect of burning, with 2 treatments: no burning (control) and burning (i.e. with three replicate plots for each treatment and site). Burning was conducted in May 2016. In each plot, 8 litterfall collectors were installed at regular intervals, according to international protocols (ICP Forests), and all biomass falling into the collectors is being monitored monthly. The specific objective of this study is to assess how prescribed burning affects the rate of generation of foliar and non-foliar litterfall biomass due to the fire. In addition, the Leaf Area Index was estimated before burning and one year later to verify possible changes in the structure of the stands. This information could be used to help minimize the negative impacts of prescribed underburning on litterfall. To our knowledge, this study represents the first attempt to evaluate the effect of prescribed burning on litterfall biomass in Europe.

Influencia de determinantes de género en la anticoncepción de estudiantes de Enfermería y Obstetricia mexicanas / Influence of gender determinants on anticonception among Mexican Nursing and Obstetrics students / Influência de determinantes de gênero na anticoncepção de estudantes de Enfermagem e Obstetrícia Mexicanas

Objetivo: Analizar la influencia de los determinantes de género en la anticoncepción de estudiantes de Enfermería y Obstetricia de la Universidad Nacional Autónoma de México (UNAM). Método: Estudio observacional analítico con enfoque cuantitativo. Se administró el cuestionario COGANT, anónimo, voluntario y autocumplimentado de forma digital. Muestreo no probabilístico, incidental. Se incluyó a todas las estudiantes mujeres que aceptaron participar en el estudio de forma voluntaria, matriculadas en la asignatura de Obstetricia I de la Escuela Nacional de Enfermería y Obstetricia de la UNAM (n = 121). Análisis descriptivo de la media, desviación típica, rango y mediana de la puntuación total. Análisis factorial y test de normalidad de K-S. Se analizaron las puntuaciones obtenidas en cada ítem mediante porcentajes utilizando SPSS v. 23. Resultados: La puntuación media del cuestionario fue 58.68, DT 8.39, rango 43-87. En este estudio se comprobó que el eje central de la relación de pareja ya no es la maternidad. No se encontró gran influencia de los condicionantes de género en la salud reproductiva de las alumnas, predominó la autonomía y una actitud más igualitaria. Sin embargo, persisten algunos estereotipos de género, como la actitud pasiva o sumisa de las mujeres y un rol de género inseguro. Conclusiones: Desde las universidades los estudiantes de Enfermería deben capacitarse en salud sexual y reproductiva con perspectiva de género para que, al involucrarse después como profesionales de enfermería en la educación sexual integral de adolescentes, promuevan la igualdad de género y normas sociales equitativas e influyan sobre la conducta sexual más segura, ya que aplaza el inicio de las relaciones sexuales y aumenta el uso de los preservativos.

Objective: To analyze the influence which gender determinants have on Nursing and Obstetrics students of the National Autonomous University of Mexico. Method: This is an analytic observational study with a quantitative focus. The COGANT questionnaire was digitally offered to be voluntarily and anonymously completed. Sampling was non-probabilistic and incidental. The sample was constituted by n = 121 women students from the Obstetrics I course who voluntarily decided to participate. A descriptive analysis which included mean, typical deviation, range, and median calculation from the total scores was carried out. A factorial analysis and a K-S normality test were performed. SPSS v. 23 was used. Results: The median score in the questionnaire was 58.68, TD =8.39, range =43 to 87. The findings suggested that maternity is no longer the main core of the couple relationship. Gender conditions were not found to be highly influential on the students' reproductive health. An autonomous and equalitarian attitude prevailed among; nevertheless, some gender stereotypes such as passive or submissive attitude and an uncertain gender role still prevailed among some students. Conclusions: Within universities, nursing students should train and strengthen their sexual and reproductive health under a gender perspective so that they can also project, and promote, gender equalitarian social norms which can foster safe health behaviors including the use of preservatives and an older age of sexual relations initiation.

Objetivo: Analisar a influência dos determinantes de género na anticoncepção de estudantes de Enfermagem e Obstetrícia da Universidade Nacional Autónoma de México (UNAM). Método: Estudo observacional analítico com enfoque quantitativo. Administrou-se o questionário COGANT, anónimo, voluntário e auto oferecido de forma digital. Amostragem não probabilística, incidental. Incluíram-se todas as estudantes mulheres que aceitaram participar no estudo de forma voluntaria, matriculadas na disciplina de Obstetrícia I da Escola Nacional de Enfermagem e Obstetrícia da UNAM, corresponderam a uma n = 121. Análise descritiva da média, desvio típico, faixa e media da pontuação total. Análise fatorial e teste de normalidade de K-S. Analisaram-se as pontuações obtidas em cada item mediante porcentagens utilizando SPSS v. 23. Resultados: A pontuação média do questionário foi 58.68, DT 8.39, faixa 43-87. Neste estudo comprovou-se que o eixo central da relação do casal já não é a maternidade. Não se encontrou grande influência das condicionantes de género na saúde reprodutiva das alunas, predominou a autonomia e uma atitude mais igualitária. Porém, persistem alguns estereótipos de género como a atitude passiva ou submissa das mulheres e um rolo de género inseguro. Conclusões: Desde as universidades os estudantes de Enfermagem devem capacitar-se na saúde sexual e reprodutiva com perspectiva de género, para que ao envolver-se depois como profissionais de enfermagem na educação sexual integral de adolescentes, promovam a igualdade de género e normas sociais equitativas e influenciem sobre uma conduta sexual mais segura, já que adia o início das relações sexuais e aumenta o uso dos preservativos.

Elastografía tipo ARFI: modificación tras tratamiento antiviral en el trasplante hepático con recidiva por VHC / ARFI elastography: changes after direct-acting antiviral treatment in transplanted livers with relapse of hepatitis C virus infection

Objetivo. Evaluar la modificación de los valores en la elastografía hepática tipo ARFI tras el tratamiento antiviral en pacientes con trasplante hepático e infección por el virus de la hepatitis C (VHC) con recidiva durante el postrasplante. Material y métodos. Se han estudiado 15 pacientes receptores de trasplante hepático con infección por el VHC y recidiva sobre el injerto durante el primer año tras el trasplante que fueron tratados con antivirales de acción directa. A todos ellos se les realizó ecografía basal, Doppler y elastografía hepática tipo ARFI en los 3 meses anteriores al inicio del tratamiento y durante los 3 meses posteriores a su finalización. En la misma semana de la elastografía se realizó analítica con perfil hepático y determinación de la carga viral (ARN-VHC) en sangre periférica mediante técnica de reacción en cadena de la polimerasa. Se ha estudiado el cambio en las velocidades de cizallamiento de la elastografía antes y después del tratamiento. El análisis estadístico se ha efectuado mediante el test de Wilcoxon para datos apareados. Resultados. Todos los pacientes alcanzaron una respuesta viral mantenida a los 3 meses de finalizar el tratamiento. Se han encontrado diferencias estadísticamente significativas en las velocidades de la elastografía, con disminución de estas tras finalizar el tratamiento (la mediana de los valores de la onda de cizallamiento previos al tratamiento fue de 1,97m/s, y tras finalizarlo fue de 1,58m/s; p=0,001). Conclusión. La velocidad de la onda de cizallamiento disminuye de manera significativa tras el tratamiento antiviral en los pacientes receptores de trasplante hepático con recidiva de la infección por VHC (AU)

Objective. To evaluate the changes in the values obtained in acoustic radiation force impulse (ARFI) elastography of the liver after antiviral treatment in patients with liver transplants and hepatitis C virus (HVC) infection recurring after transplantation. Material and methods. We studied 15 patients infected with HVC who had received liver transplants where an HVC infection recurring in the graft within one year after the transplant was treated with direct-acting antivirals. All patients underwent ultrasonography including Doppler and ARFI elastography in the three months before starting treatment with direct-acting antivirals (baseline study) and again in the three months after finishing the treatment. In the same week when the elastography study was done, liver function tests were done and the viral load (HCV RNA) was determined in peripheral blood with the polymerase chain reaction method. We used the Wilcoxon test for paired samples to compare the changes in the shear wave velocities before and after treatment. Results. All patients achieved a virologic response that was sustained at 3 months after the end of treatment. On elastography, median shear wave velocities decreased after treatment (1.97m/s before treatment vs. 1.58m/s after treatment; p=0.001). Conclusion. The shear wave velocity decreased significantly after antiviral treatment in patients who had relapsed HVC infection after liver transplantation (AU)

Differences between migrants and Spanish-born population through the HIV care cascade, Catalonia: an analysis using multiple data sources.

Migrants are considered a key group at risk for HIV infection. This study describes differences between migrants and the Spanish-born population as they progress through the HIV care cascade in Catalonia, Spain. This study found that among people reached by prevention activities, migrants had a higher number of barriers to access HIV testing services than Spanish-born people, driven primarily by shared risk factors. Between 2001 and 2013, 9829 new HIV diagnoses were reported in Catalonia, the proportion of migrants increasing from 24% in 2001 to 41% in 2013. Compared with Spanish-born people, migrants had a higher proportion of women at diagnosis (24·6% vs. 16·7%), and were younger (median age of 33 vs. 37). The most frequent at-risk population was MSM (men who have sex with men) in both migrants and Spanish-born people, (40% and 43%, respectively), although there were significant differences by region of origin. People from sub-Saharan Africa had the highest proportion of late diagnosis (63·7%). Compared with the Spanish-born population, migrants on follow-up had a lower proportion of people on antiretroviral therapy (ART) (93·7% vs. 90·8%, P < 0·001) and with viral suppression (87·2% vs. 82·9%, P < 0·001). Migrants have higher number of barriers to access HIV testing services, lower retention rates and proportions on ART as compared with Spanish-born people, these differences not being uniform between migrants from different regions.

ARFI elastography: changes after direct-acting antiviral treatment in transplanted livers with relapse of hepatitis C virus infection. / Elastografía tipo ARFI: modificación tras tratamiento antiviral en el trasplante hepático con recidiva por VHC.

OBJECTIVE: To evaluate the changes in the values obtained in acoustic radiation force impulse (ARFI) elastography of the liver after antiviral treatment in patients with liver transplants and hepatitis C virus (HVC) infection recurring after transplantation. MATERIAL AND METHODS: We studied 15 patients infected with HVC who had received liver transplants where an HVC infection recurring in the graft within one year after the transplant was treated with direct-acting antivirals. All patients underwent ultrasonography including Doppler and ARFI elastography in the three months before starting treatment with direct-acting antivirals (baseline study) and again in the three months after finishing the treatment. In the same week when the elastography study was done, liver function tests were done and the viral load (HCV RNA) was determined in peripheral blood with the polymerase chain reaction method. We used the Wilcoxon test for paired samples to compare the changes in the shear wave velocities before and after treatment. RESULTS: All patients achieved a virologic response that was sustained at 3 months after the end of treatment. On elastography, median shear wave velocities decreased after treatment (1.97m/s before treatment vs. 1.58m/s after treatment; p=0.001). CONCLUSION: The shear wave velocity decreased significantly after antiviral treatment in patients who had relapsed HVC infection after liver transplantation.