A Secret Shopper Study of Language Accessibility of Community-Based Behavioral Health Services for Children in Families Who Speak Spanish and English.

OBJECTIVE: The objective of this study was to compare outpatient behavioral health scheduling for children in Spanish-speaking families in Pennsylvania with that for children in families who speak English. STUDY DESIGN: We made paired English and Spanish telephone calls to outpatient behavioral health facilities using a standardized script, describing a simulated, stable, Medicaid-insured child. Facilities were identified using the Pennsylvania Department of Human Services Online Provider Directory for Mental Health and Substance Abuse Services, which had 288 outpatient facilities with nonduplicate telephone numbers. An English-language caller following a script made up to 2 call attempts per facility from December 2019 through February 2020. The 126 facilities that did not answer the phone, accept Medicaid, or see children were removed. A Spanish-language caller then made up to 2 scripted call attempts to the 162 remaining facilities. The primary outcome was whether the facility tried to schedule an appointment for the simulated adolescent. RESULTS: A total of 125 facilities answered both English- and Spanish-language calls. For the English-language caller, 71% of facilities attempted to schedule an appointment and 100% communicated in the caller's preferred language. For the Spanish-language caller, 24% attempted to schedule an appointment (P < .001) and 25% communicated in the caller's preferred language (P < .001). CONCLUSIONS: Among outpatient behavioral health facilities for Medicaid-insured children in Pennsylvania, there were inequities in access to appointments for families who speak Spanish compared with English. This is a modifiable barrier to care. Community-based behavioral health care for children should strengthen language access training, contracting, and oversight.

Impact of social distancing from the COVID-19 pandemic on the immuno-inflammatory response of older adults.

BACKGROUND: Older adults, as the population considered at increased risk for severe COVID-19, were the most impacted by social isolation. Thus, this study aimed to assess the salivary immune/inflammatory response of older adults before and during the COVID-19 pandemic. METHODS: A cohort of 11 older adults (mean age 66.8 ± 6.1) was followed at three different time points: before (S1) and after 6 (S2) and 20 months (S3) of the beginning of the COVID-19 pandemic in Brazil. Unstimulated saliva samples were obtained to assess the levels of antibodies (secretory IgA, IgG and IgM) by ELISA and cytokines (IL-2, IL-5, IL-6, IL-8 and IL-10, TSLP, IFN-γ, TNF-α) by multiplex analysis. Significant differences were evaluated using the Kruskal-Wallis test with Dunn's post-test. RESULTS: None volunteer presented periodontal disease or caries. All volunteers received at least two doses of the COVID-19 vaccines after S2 and before S3. A tendency to increase salivary levels of SIgA and IgM at S2 and of IgG at S3 were observed compared to the values found at S1 and S2. Significantly decreased levels of IL-2 and IL-5 were found at S2 and S3 (p < 0.001) time points. Lower levels of IFN-γ were found at S2 as compared to the values observed at S1 (p < 0.01). A significant decrease in the IFN-γ/IL-10 ratio was found at S2 (p < 0.01). When assessing the Th1/Th2 ratios, a significant decrease was found in the IFN-γ/TSLP ratio at S2 (p < 0.001) and S3 (p < 0.001) when compared to the values at S1. In addition, a significant increase was observed in the TNF-α/IL-5 ratio at S2 (p < 0.001) and S3 (p < 0.001) in comparison to the values at S1. In a similar way, an increase in the TNF-α/IL-6 ratio (Fig. 5E) was observed at S3 (p < 0.001) when compared to the values at S1. CONCLUSIONS: Overall, this study provides valuable insights into the impact of COVID-19-induced social isolation on immune/inflammatory responses in the upper airway mucosa, particularly those present in oral cavity, of older adults. It demonstrates that a controlled shift in Th1 and Th2 immune responses, both during infection and post-vaccination, can create favorable conditions to combat viral infections without exacerbating the immune response or worsening the pathology.

Exclusion of Families Who Speak Languages Other than English from Federally Funded Pediatric Trials.

OBJECTIVE: To determine whether individuals in the United States who speak languages other than English (LOE) are excluded from federally funded pediatric clinical trials and whether such trials adhere to the National Institutes of Health policy regarding inclusion of members of minority groups. STUDY DESIGN: Using ClinicalTrials.gov, we identified all completed, federally funded, US-based trials inclusive of children ≤17 and focused on one of 4 common chronic childhood conditions (asthma, mental health, obesity, and dental caries) as of June 18, 2019. We reviewed ClinicalTrials.gov online content, as well as published manuscripts linked to ClinicalTrials.gov entries, to abstract information about language-related exclusion criteria. Trials were deemed to exclude LOE participants/caregivers if explicit statements regarding exclusion were identified in the study protocol or published manuscript. RESULTS: Of total, 189 trials met inclusion criteria. Two-thirds (67%) did not address multilingual enrollment. Of the 62 trials that did, 82% excluded LOE individuals. No trials addressed the enrollment of non-English, non-Spanish-speaking individuals. In 93 trials with nonmissing data on ethnicity, Latino individuals comprised 31% of participants in trials that included LOE individuals and 14% of participants in trials that excluded LOE individuals. CONCLUSIONS: Federally funded pediatric trials in the United States do not adequately address multilingual enrollment, a seeming violation of federal and contractual requirements for accommodation of language barriers by entities receiving federal funding.

Use of Adolescent "Community Researchers" to Address Obesity Among Mexican Immigrant Families.

Background: Mexican-American immigrants have a disparate prevalence of overweight/obesity, and obesogenic illness. One approach is to train immigrant adolescents as "community researchers." Aims: (1) Design a program to train community researchers to address obesity among Mexican immigrant families and (2) identify the key components of a successful program. Methods: The content included an overview of community research/citizen science; obesity and food insecurity; study design and data collection and analysis for nutrition and physical activity. The students concluded by analyzing the results of group concept mapping (GCM) activities. Results: Post-session class discussions reflected an increased understanding of weekly topics. Analysis of GCM data suggests that members of the Mexican immigrant community may use emotional eating as a way to manage structural stigma, eventually leading to truncal obesity, T2DM and increased cardiovascular risk. Conclusions: Adolescents of Mexican heritage can have a major impact in promoting healthy lifestyles in their communities.

Hydrocarbons and other risks in a beekeeping area of México: the precautionary principle for prevention and biotechnology for remediation.

The Yucatan Peninsula is the most important beekeeping region. However, the presence of hydrocarbons and pesticides violates the human right to a healthy environment twice over; it can affect human beings directly due to its toxicological characteristics, but it also constitutes a risk, not very well dimensioned, regarding the loss of biodiversity of the ecosystem via the impact on pollination. On the other hand, the precautionary principle obliges the authorities to prevent damage to the ecosystem that may be caused by the productive activity of individuals. Although there are studies that separately warn about the decrease of bees in the Yucatan due to industrial activity, this work has the novelty of presenting an intersectoral analysis of the risk that includes the soy industry, the swine industry and the tourist industry. The latter incorporates a new risk not considered until now, which is the presence of hydrocarbons in the ecosystem. Additionally, we can demonstrate that hydrocarbons, such as diesel and gasoline, should be avoided when using no genetically modified organisms (GMOs) in bioreactors. The objective of this work was to propose the precautionary principle around the risks in a beekeeping area and to propose biotechnology without using GMOs.

Psychological Impact of the COVID-19 Pandemic on Dentists in Latin America's Epicenter: São Paulo, Brazil.

The present study aimed to assess the prevalence and associated factors of stress and anxiety symptoms among dentists during the COVID-19 pandemic in the state of São Paulo, Brazil. A structured questionnaire was sent electronically to 93,280 dentists with active registration in the Dental Council of São Paulo, Brazil, enquiring about information regarding the first-wave peak period in Brazil. Descriptive analyses of background characteristics, perceptions of preparedness, and psychological impact were calculated. Multiple logistic regression analysis was performed, and independent variables that showed p < 0.20 were used in the adjusted logistic regression model to compare the psychological impact on dental professionals. Among the 2113 respondents, female participants had 63% lower chance of reporting anxiety than males. Older dentists had a lower likelihood of reporting anxiety compared to 21-30-year-old dentists (p ≤ 0.05). Dentists working in the public health service were 1.78 times more likely to report anxiety than those who worked in private practice. Finally, dentists in the COVID-19 high-risk group and those with a family or team member with a positive COVID-19 diagnosis were more likely to have anxiety. This study can help dental and other healthcare professionals to better understand the consequences of COVID-19 in terms of mental health.

Aceite de Clavo (Eugenol®) como Anestésico en la Especie Panaque Cochliodon-Steindachner, 1879 (Cucha de Ojos Azules) / Clove Oil (Eugenol®) as an Anesthetic in the Species Panaque Cochliodon-Steindachner, 1879 (Blue-Eyed Pleco) / Óleo de Cravo (Eugenol®) como Anestésico na Espécie Panaque Cochliodon-Steindachner, 1879 (Cascudo De Olhos Azuis)

Resumen Introducción: la cucha de ojos azules (Panaquecochliodon) es una especie endémica de la cuenca del Cauca y el Magdalena. Sin embargo, no se tiene mucha información sobre esta especie, incluida la ausencia de un protocolo de sedación adecuado para el trabajo en cautiverio con esta especie. Objetivo: estandarizar un protocolo de sedación del P. cochliodon. Materiales y métodos: se evaluaron diferentes concentraciones del sedante Eugenol que iban desde 20 a 40 mg/L; se adoptaron 4 tipos de sedación y 5 tipos de recuperación, encontrando así los grados de sedación adecuados para los diferentes procedimientos de manejo en confinamiento que se realizaron con esta especie. Resultados: todos los ejemplares alcanzaron la sedación tipo 4 y la recuperación tipo 5 sin mortalidad. Significativamente la concentración a la cual los ejemplares demoraron más tiempo en alcanzar la sedación tipo 4 y recuperación tipo 5 fue la de 20 mg/L, las demás concentraciones no presentaron diferencias entre sí, pero indican una tendencia inversa con respecto a la concentración y el tiempo. Conclusiones: todas las concentraciones evaluadas son seguras para el manejo de P. cochliodon de 314±11,6 gr, no se presentó mortalidad; las concentraciones de 30 a 35 mg/L, ofrecen 2,6 minutos de trabajo, sin efectos deletéreos aparentes sobre la especie.

Abstract Introduction: the blue-eyed pleco {Panaque cochliodon) is a species endemic to the Cauca and Magdalena basin. However, not much information is available on this species, including the absence of an adequate sedation protocol for captive work with this species. Objetive: this research standardizes a sedation protocol for P. cochliodon. Materials and methods: for this purpose, different dosages and concentrations of the sedative Eugenol ranging from 20 to 40 mg/L were evaluated and 4 types of sedation and 5 types of recovery were adopted, thus finding the appropriate degrees of sedation for the different confinement management procedures that were performed with this species. Results: all specimens reached type 4 sedation and type 5 recovery without mortality. Significantly, the concentration at which the specimens took the longest time to achieve type 4 sedation and type 5 recovery was 20 mg / L, the other concentrations did not show differences between them, but indicate an inverse trend with respect to the concentration and experimental time. Conclusions: all the concentrations evaluated are safe for the management of P. cochliodon of 314 ± 11.6 gr, there was no mortality; concentrations of 30 to 35 mg / L, offer 2.6 minutes of work, without apparent deleterious effects on the species.

Resumo Introdução: o cascudo de olhos azuis {Panaquecochliodon) é uma espécie endémica da bacia do Cauca e Magdalena. Contudo, não há muita informação disponível sobre esta espécie, incluindo a ausência de um protocolo de sedação adequado para o trabalho em cativeiro com esta espécie. Objetivo: Esta investigação padronizou um protocolo de sedação para o P. cochliodon. Materiais e métodos: para tanto, foram avaliadas diferentes dosagens e concentrações do sedativo Eugenol variando de 20 a 40 mg/l e adotados 4 tipos de sedação e 5 tipos de recuperação, encontrando-se assim os graus de sedação adequados para os diferentes confinamentos procedimentos de manejo que foram realizados com esta espécie. Resultados: todos os espécimes alcançaram sedação tipo 4 e recuperação tipo 5 sem mortalidade. Significativamente, a concentração na qual as amostras demoraram mais tempo para atingir a sedação do tipo 4 e recuperação do tipo 5 foi de 20 mg/l, as demais concentrações não apresentaram diferenças entre si, mas indicam uma tendência inversa em relação à concentração e ao tempo. Conclusões: todas as concentrações avaliadas são seguras para o manejo de P. cochliodon de 314 ± 11,6 gr, não houve mortalidade; concentrações de 30 a 35 mg/l, oferecem 2,6 minutos de trabalho, sem efeitos deletérios aparentes para a espécie.

Salivary Proteome, Inflammatory, and NETosis Biomarkers in Older Adult Practitioners and Nonpractitioners of Physical Exercise.

Since aging has been associated with increased production of inflammatory biomarkers, the ability to monitor older adults repeatedly is highly desirable, and saliva is an interesting biofluid for the search of biomarkers, as it is easily accessible in a noninvasive manner. However, given the incipient knowledge of salivary biomarkers in aging and its relationship to physical exercise, the present study is aimed at evaluating the protein expression and the levels of inflammatory and NETosis biomarkers in the saliva of practitioners (PE) and nonpractitioners (NPE) of physical exercise older adults. Six (6) practitioner and 4 nonpractitioner older adults were enrolled in this study. Unstimulated whole saliva was collected for analysis of the proteome by label-free mass spectrometry, as well as of the inflammatory status by evaluation of C-reactive protein (CRP), vascular endothelial growth factor (VEGF), and cytokines (TNF-α, interleukin- (IL-) 1ß, and IL-8), while NETosis was assessed by myeloperoxidase (MPO) and neutrophil elastase. Regarding oral health, the decayed, missing, and filled teeth (DMF-T) index, bleeding on probing, suppuration, and probing depth measurement (mm) were evaluated. In addition, functional capacity was investigated using the General Physical Fitness Index (GPFI). In relation to the proteome analysis, 93 and 143 proteins were found exclusively in the PE and NPE groups, respectively; 224 proteins were common to both groups. Among these proteins, 10 proteins showed statistical difference (p < 0.05) between the groups: alpha-2-macroglobulin, component 3 of the complement, serotransferrin, and protein soluble in brain acid 1 were less expressed, while lactotransferrin, alpha-amylase 1, S100-A8, S100-A9, lactoperoxidase, and galectin-3 binding protein were more expressed in the PE group. No differences between groups were observed in the analysis of inflammatory and NETosis biomarkers. This study shows the potential utility of saliva for detecting protein biomarkers in a noninvasive biological sample of the elderly population.

Association Between Adverse Childhood Experiences at Age 5 Years and Healthcare Utilization at Age 9 Years.

OBJECTIVE: To determine associations between adverse childhood experiences (ACEs) at age 5 years and healthcare utilization patterns at age 9 years. STUDY DESIGN: We conducted a secondary analysis using longitudinal data from the Fragile Families and Child Wellbeing Study. Caregivers (n = 2521) provided data on their child's ACEs at age 5 years and on 4 types of healthcare utilization at age 9 years: past-year well visits, dental visits, primary care sick visits for injury or illness, and emergency room (ER) visits. Logistic regression analysis was used to examine the association between ACEs at age 5 and each type of healthcare utilization, adjusting for relevant sociodemographic covariates. RESULTS: Among the 2521 children (51% male, 48% Non-Hispanic Black), 77% had ≥1 ACE at age 5. Children with ≥4 ACEs had lower odds of a dental visit (aOR, 0.51; 95% CI, 0.29-0.91) and higher odds of a primary care sick visit (aOR, 1.77; 95% CI, 1.20-2.64) and an ER visit (aOR, 1.70; 95% CI, 1.11-2.59) compared with children with no reported ACEs. CONCLUSION: Our findings demonstrate suboptimal healthcare utilization patterns among families with ACEs and indicate a need for targeted interventions that support appropriate healthcare utilization for children who endure adversity.

Kinetic, Thermodynamic, Physicochemical, and Economical Characterization of Pectin from Mangifera indica L. cv. Haden Residues.

The effect of temperature (60, 70, 80, and 90 °C) and time (30, 45, 60, 75, and 90 min) on citric acid extraction of Haden mango (Mangifera indica L. cv. Haden) peel pectin was evaluated in the present study. In order to obtain a better understanding of both the extraction process and the characteristics of the pectin (obtained from an agro-industrial waste) for a future scaling process, the following characterizations were performed: (1) Kinetic, with the maximum extraction times and yields at all evaluated temperatures; (2) thermodynamic, obtaining activation energies, enthalpies, entropies, and Gibbs free energies for each stage of the process; (3) physicochemical (chemical analysis, monosaccharide composition, degree of esterification, galacturonic acid content, free acidity, Fourier-transform infrared spectroscopy, thermogravimetric and derivative thermogravimetric analyses); and (4) economical, of the pectin with the highest yield. The Haden mango peel pectin was found to be characterized by a high-esterified degree (81.81 ± 0.00%), regular galacturonic acid content (71.57 ± 1.26%), low protein (0.83 ± 0.05%) and high ash (3.53 ± 0.02%) content, low mean viscometric molecular weight (55.91 kDa), and high equivalent weight (3657.55 ± 8.41), which makes it potentially useful for food applications.

Unusual clinical phenotype of Stargardt disease / Fenótipo clínico incomum da doença de Stargardt

ABSTRACT Mutations in the ABCA4 gene are a common cause of Stargardt disease; however, other retinal phenotypes have also been associated with mutations in this gene. We describe an observational case report of an unusual clinical phenotype of Stargardt disease. The ophthalmological examination included best corrected visual acuity, color and autofluorescence photography, fluorescein angiography, optical coherence tomography, and electrophysiology tests. Targeted next-generation sequencing of 99 genes associated with inherited retinal dystrophies was performed in the index patient. A 48-year-old woman presented with a best corrected visual acuity of 20/25 and 20/20. Fundoscopy revealed perifoveal yellow flecked-like lesions. Fluorescein angiography and fundus autofluorescence findings were consistent with pattern dystrophy. Pattern electroretinogram demonstrated bilateral decrease of p50 values. Genetic testing identified two heterozygous missense mutations, c.428C>T, p.(Pro143Leu) and c.3113C>T, p.(Ala.1038Val), in the ABCA4 gene. Based on our results, we believe that these particular mutations in the ABCA4 gene could be associated with a specific disease phenotype characterized by funduscopic appearance similar to pattern dystrophy. A detailed characterization of the retinal phenotype in patients carrying specific mutations in ABCA4 is crucial to understand disease expression and ensure optimal clinical care for patients with inherited retinal dystrophies.

RESUMO Mutações no gene ABCA4 são causa comum da doença de Stargardt, mas outros fenótipos da retina também foram associados a mutações nesse gene. Apresentamos um relato de caso observacional de um fenótipo clínico incomum da doença de Stargardt. O exame oftalmológico incluiu a acuidade visual com melhor correção, fotografia em cores e com autofluorescência, angiofluoresceinografia, tomografia de coerência óptica e testes de eletrofisiologia. Na paciente em questão, realizou-se o sequenciamento de próxima geração de 99 genes associados a distrofias retinais hereditárias. Tratava-se de uma mulher de 48 anos com melhor acuidade visual corrigida de 20/25 e 20/20. A fundoscopia revelou lesões puntiformes amarelas perifoveais. Os resultados da angiofluoresceinografia e da autofluorescência do fundo de olho foram consistentes com distrofia em padrão. A eletrorretinografia por padrões mostrou diminuição bilateral dos valores de p50. Os testes genéticos revelaram duas mutações missense heterozigóticas, c.428C>T, p. (Pro143Leu) e c.3113C>T, p. (Ala.1038Val), no gene ABCA4. Nossos resultados nos fazem pensar que essas mutações específicas em ABCA4 talvez possam estar associadas a um fenótipo específico da doença, caracterizado por uma aparência fundoscópica semelhante à da distrofia em padrão. Uma caracterização detalhada do fenótipo da retina em pacientes portadores de mutações específicas em ABCA4 é crucial para compreender a expressão da doença e para garantir o tratamento clínico ideal para pacientes com distrofias retinais hereditárias.

Effect of solvent polarity on the Ultrasound Assisted extraction and antioxidant activity of phenolic compounds from habanero pepper leaves (Capsicum chinense) and its identification by UPLC-PDA-ESI-MS/MS.

Phenolic compounds are secondary metabolites involved in plant adaptation processes. The development of extraction procedures, quantification, and identification of this compounds in habanero pepper (Capsicum chinense) leaves can provide information about their accumulation and possible biological function. The main objective of this work was to study the effect of the UAE method and the polarity of different extraction solvents on the recovery of phenolic compounds from C. chinense leaves. Quantification of the total phenolic content (TPC), antioxidant activity (AA) by ABTS+ and DPPH radical inhibition methods, and the relation between the dielectric constant (ε) as polarity parameter of the solvents and TPC using Weibull and Gaussian distribution models was analyzed. The major phenolic compounds in C. chinense leaves extracts were identified and quantified by UPLC-PDA-ESI-MS/MS. The highest recovery of TPC (24.39 ± 2.41 mg GAE g-1 dry wt) was obtained using MeOH (50%) by UAE method. Correlations between TPC and AA of 0.89 and 0.91 were found for both radical inhibition methods (ABTS+ and DPPH). The Weibull and Gaussian models showed high regression values (0.93 to 0.95) suggesting that the highest phenolic compounds recovery is obtained using solvents with "ε" values between 35 and 52 by UAE. The major compounds were identified as N-caffeoyl putrescine, apigenin, luteolin and diosmetin derivatives. The models presented are proposed as a useful tool to predict the appropriate solvent composition for the extraction of phenolic compounds from C. chinense leaves by UAE based on the "ε" of the solvents for future metabolomic studies.

Unusual clinical phenotype of Stargardt disease.

Mutations in the ABCA4 gene are a common cause of Stargardt disease; however, other retinal phenotypes have also been associated with mutations in this gene. We describe an observational case report of an unusual clinical phenotype of Stargardt disease. The ophthalmological examination included best corrected visual acuity, color and autofluorescence photography, fluorescein angiography, optical coherence tomography, and electrophysiology tests. Targeted next-generation sequencing of 99 genes associated with inherited retinal dystrophies was performed in the index patient. A 48-year-old woman presented with a best corrected visual acuity of 20/25 and 20/20. Fundoscopy revealed perifoveal yellow flecked-like lesions. Fluorescein angiography and fundus autofluorescence findings were consistent with pattern dystrophy. Pattern electroretinogram demonstrated bilateral decrease of p50 values. Genetic testing identified two heterozygous missense mutations, c.428C>T, p.(Pro143Leu) and c.3113C>T, p.(Ala.1038Val), in the ABCA4 gene. Based on our results, we believe that these particular mutations in the ABCA4 gene could be associated with a specific disease phenotype characterized by funduscopic appearance similar to pattern dystrophy. A detailed characterization of the retinal phenotype in patients carrying specific mutations in ABCA4 is crucial to understand disease expression and ensure optimal clinical care for patients with inherited retinal dystrophies.

Evaluation of a multidisciplinary global health online course in Mexico.

BACKGROUND: Global Health Education (GHE) focuses on training proactive global citizens to tackle health challenges in an increasingly interconnected and interdependent world. Studies show that health professionals in training have reported that GHE has improved their teamwork, responsiveness to contextual factors that impact health, and understanding of health systems; however, there is little research on the impact of GHE courses in undergraduate settings, especially in low and middle-income countries (LMICs). METHODS: Our study analyzes a multidisciplinary online global health course at Tecnologico de Monterrey, México. We conducted a cross-sectional study with pre- and post-design. Students who took the multidisciplinary course of Global Health for Leaders in the Fall of 2019 (n = 153) and Spring of 2020 (n = 348) were selected for this study. Using a five-point Likert scale (strongly agree to strongly disagree), the survey assessed seven competencies as well as questions about course expectations, takeaways, and recommendations to improve the course. We performed descriptive statistical analyses comparing the combined pre-tests (from Fall and Spring cohorts) to the combined post-tests. Fisher's exact test was used to compare the samples. RESULTS: Of the 501 pre-course surveys administered, 456 responses were completed in the pre-course and 435 in the post-course (91% overall response rate). Only 8.7% of the respondents in the pre-course survey strongly agreed that they could describe fundamental aspects of global health such as the Millennium Development Goals or Sustainable Development Goals, in contrast to a 56% of the students who strongly agreed in the post-course survey (p < 0.001). Similar differences were captured in understanding the global burden of disease, social determinants of health, the effects of globalization in health, health systems' goals and functions, and human rights. 38% felt that the course helped them develop a more empathetic perception of the suffering of others experiencing global health-related issues. CONCLUSION: In this study, we have presented our experience in teaching an online global health course for multidisciplinary undergraduates in a LMIC. The competencies reported by our students indicate that the course prepared them to confront complex global health issues.

Facotrabeculectomía por dos vías como tratamiento combinado de pacientes con glaucoma y catarata / Two-site phacotrabeculectomy as combined therapy for patients with glaucoma and cataract

RESUMEN Objetivo: Determinar los resultados de la facotrabeculectomía por dos vías como tratamiento combinado de pacientes cubanos con glaucoma y catarata. Métodos: Se realizó un estudio observacional descriptivo longitudinal prospectivo en pacientes adultos cubanos tratados con facotrabeculectomía en el Servicio de Glaucoma del Instituto Cubano de Oftalmología "Ramón Pando Ferrer" entre junio del año 2016 y abril de 2017. El universo estuvo constituido por todos los pacientes operados con facotrabeculectomía por dos vías. La muestra la integraron pacientes operados por un mismo cirujano, quienes estuvieron de acuerdo con participar en la investigación. Se excluyeron aquellos con cirugía intraocular previa. Salieron del estudio los que no pudieron mantener el seguimiento en la institución. Se estudiaron las variables edad, sexo, color de la piel, agudeza visual mejor corregida, presión intraocular, número de medicamentos hipotensores oculares y complicaciones presentadas. El seguimiento fue por dos años con consultas al día siguiente, a los siete y a los treinta días; a los tres y a los seis meses; al año y a los dos años. Resultados: Se observaron 31 pacientes. La edad promedio fue de 70 años, con predominio del sexo femenino y el color de la piel no blanco; la agudeza visual mejor corregida preoperatoria media 0,58 y la posoperatoria 0,73. La presión intraocular media preoperatoria 22,04 mmHg y a los dos años 16,37 mmHg. La media de los medicamentos hipotensores preoperatorios fue 3,0 y 0,3 a los dos años. Las complicaciones más frecuentes resultaron la ruptura transquirúrgica de la cápsula posterior y la opacidad posquirúrgica de la cápsula posterior. Conclusiones: Con la facotrabeculectomía por dos vías disminuye la presión intraocular; mejora la agudeza visual mejor corregida y se reduce el número de fármacos hipotensores oculares al menos durante dos años. Las complicaciones asociadas a la técnica son mínimas(AU)

ABSTRACT Objective: Determine the results of two-site phacotrabeculectomy as combined therapy for Cuban patients with glaucoma and cataract. Methods: An observational prospective longitudinal descriptive study was conducted of Cuban patients undergoing phacotrabeculectomy at the Glaucoma Service of Ramón Pando Ferrer Cuban Institute of Ophthalmology from June 2016 to April 2017. The study universe was all the patients undergoing two-site phacotrabeculectomy. The sample was patients operated on by the same surgeon who consented to participate in the research. Patients with a history of intraocular surgery were excluded, as well as those who could not be followed up at the institution. The variables considered were age, sex, skin color, best corrected visual acuity, intraocular pressure, number of ocular hypotensive drugs, and complications developed. Follow-up extended for two years with visits on the next day, at seven and thirty days, at three and six months, and at one and two years. Results: Thirty-one patients were observed. Mean age was 70 years, with a predominance of the female sex and non-white skin color. Best corrected visual acuity was 0.58 preoperative and 0.73 postoperative. Mean preoperative intraocular pressure was 22.04 mmHg, whereas at two years it was 16.37 mmHg. Hypotensive drugs averaged 3.0 preoperative and 0.3 at two years. The most common complications were intraoperative posterior capsule rupture and postsurgical posterior capsule opacity. Conclusions: Two-site phacotrabeculectomy reduces intraocular pressure, improves best corrected visual acuity and lowers the number of ocular hypotensive drugs for at least two years. The complications associated to the technique are minimum(AU)

Papiloma conjuntival / Conjunctival papilloma

RESUMEN El papiloma conjuntival es un tumor de células escamosas adquirido, benigno, que se puede presentar a cualquier edad, pero más frecuentemente en la tercera y cuarta décadas de la vida. Los papilomas están asociados con la infección del virus papiloma humano, usualmente los tipos 6 y 11. Se presenta un paciente quien se encuentra en la cuarta década de la vida, fumador. Acudió al Servicio de Oculoplastia por aumento del volumen conjuntival en el ojo izquierdo. Luego del interrogatorio y de un examen ocular exhaustivo, se realizó el diagnóstico clínico de papiloma conjuntival recurrente. Se propuso exéresis, crioterapia y biopsia de las lesiones conjuntivales. Posterior a la intervención, se confirmó el diagnóstico anatomopatológico y se reajustó el tratamiento tópico ocular con interferón, con lo cual se obtuvieron resultados satisfactorios(AU)

ABSTRACT Conjunctival papilloma is a benign acquired squamous cell tumor occurring at any age, but more commonly in the third and fourth decades of life. Papillomas are associated to human papillomavirus infection, usually of types 6 and 11. A case is presented of a male smoker patient in his fourth decade of life. The patient attended the Oculoplastics Service due to conjunctival volume increase in his left eye. Interrogation and exhaustive ocular examination led to the clinical diagnosis of recurrent conjunctival papilloma. Exeresis, cryotherapy and biopsy of the conjunctival lesions were indicated. The anatomopathological diagnosis was confirmed after the intervention and a readjustment was made of the topical ocular treatment with interferon, with which satisfactory results were obtained(AU)

Baseline for plastic and hydrocarbon pollution of rivers, reefs, and sediment on beaches in Veracruz State, México, and a proposal for bioremediation.

Plastic and hydrocarbon pollution in aquatic ecosystems is a worldwide reality and serious concern today. Plastic debris presents a threat to ecosystems and organisms. Hydrocarbons are also considered priority pollutants. The hydrophobicity of the polymer in combination with the high surface area causes plastics to act as a vector for organic contaminants such as hydrocarbons. The first aim of this work was to evaluate the presence of plastic and hydrocarbon pollution in water from two reefs and two rivers and to identify plastic in six sediment beaches in Veracruz State, Mexico. In addition, the second aim was to analyse the ability of a bacterial consortium to biodegrade hydrocarbons in an airlift bioreactor and to identify degrading bacterial strains of polyethylene terephthalate (PET). Microplastics (100 nm-5 mm) were found in four water samples. Fragments of plastic collected from the reefs ranged in size from 0.716 to 32 µm and in rivers from 0.833 to 784 µm. On the sediment beaches, macroplastics of sizes 2-10 cm were detected. A number of hydrocarbons were also detected in the water samples of both reefs and one river, including n-octane, n-nonane, phenanthrene, n-eicosane, n-dotriacontane, n-hexatriacontane, n-triacontane, and n-tetratriacontane. As a biotechnological alternative for remediation of hydrocarbons and plastics, we attempted to produce a collection of native microorganisms able to degrade them. This work shows results from the bioprospection of a bacterial consortium (Xanthomonas, Acinetobacter bouvetii, Shewanella, and Aquamicrobium lusatiense) for hydrocarbon biodegradation in an airlift bioreactor. The tested consortium was able to successfully degrade the maximum diesel concentration (20 g L-1) tested for 10 days. Also, the first visual evidence of PET degradation by an isolated forest-native bacterial strain showed that Bacillus muralis is the most efficient degrader.

Shared Reading at Age 1 Year and Later Vocabulary: A Gene-Environment Study.

OBJECTIVE: To assess the extent to which associations between shared reading at age 1 years and child vocabulary at age 3 years differ based on the presence of sensitizing alleles in the dopaminergic and serotonergic neurotransmitter systems. STUDY DESIGN: We conducted a secondary analysis of data from a national urban birth cohort using mother reports in conjunction with child assessments and salivary genetic data. Child vocabulary was assessed using the Peabody Picture Vocabulary Test. The primary exposure was mother-reported shared reading. We used data on gene variants that may affect the function of the dopaminergic and serotonergic systems. We examined associations between shared reading and Peabody Picture Vocabulary Test score using multiple linear regression. We then included interaction terms between shared reading and the presence of sensitizing alleles for each polymorphism to assess potential moderator effects adjusting for multiple comparisons. RESULTS: Of the 1772 children included (56% black, 52% male), 31% of their mothers reported reading with their child daily. Daily shared reading was strongly associated with child Peabody Picture Vocabulary Test scores in unadjusted (B = 7.9; 95% CI, 4.3-11.4) and adjusted models (B = 5.3; 95% CI, 2.0-8.6). The association differed based on the presence of sensitizing alleles in the dopamine receptor 2 and serotonin transporter genes. CONCLUSIONS: Among urban children, shared reading at age 1 years was associated with greater vocabulary at age 3 years. Although children with sensitizing alleles on the dopamine receptor 2 and serotonin transporter genes were at greater risk when not read to, they fared as well as children without these alleles when shared reading occurred.

Effects of Early Literacy Promotion on Child Language Development and Home Reading Environment: A Randomized Controlled Trial.

Objective: To determine if early literacy promotion, which consisted of board books and reading promotion beginning with newborns, is more effective than standard literacy promotion beginning at 6 months. Study design: Hybrid type 1 randomized controlled implementation trial of Medicaid-eligible newborns. Prior to 6 months of age, early literacy promotion participants received board books and reading promotion at well visits plus weekly text messages on reading, while standard literacy promotion participants only received weekly text messages on safety. Both groups received board books and reading promotion at well visits after 6 months as part of Reach Out and Read. Measures included proportion who received board books to assess implementation and StimQ Read Subscale (SQRS) scores and Preschool Language Scale-Fifth Edition (PLS-5) scores at 6 and 24 months to assess outcomes. Differences in measures were assessed using intention-to-treat analysis. Results: Of 120 newborns enrolled, most were African American, resided with a single parent, or had a parent with ≤high school education. Overall 82% of early literacy promotion participants received books/counseling at well visits <6 months old. Children in the early literacy promotion arm had greater SQRS scores (11.0 vs 9.4, P = .006) but similar PLS-5 scores at 6 months, but there were no differences in SQRS or PLS-5 scores between groups at 24 months. Conclusions: Implementation of a literacy promotion program early in infancy was associated with richer home reading environments at 6 months but did not improve language development. Although an early literacy program was feasible, additional study may be needed to assess other potential benefits. Trial registration: Clinicaltrials.gov: NCT02713659.

Lensectomía refractiva en coloboma de iris / Refractive lensectomy for iris coloboma

RESUMEN El coloboma de iris es un defecto congénito, que se describe como un orificio, fisura o hendidura en dicha estructura.​ Esta condición tiene la posibilidad de ser hereditaria o aparecer sin historia familiar previa. Se presenta un caso de un paciente de 51 años de edad con coloboma bilateral de iris asimétrico e hipermetropía, quien acudió a la consulta médica con el deseo de independizarse de su corrección óptica habitual. Se propuso cirugía facorrefractiva de ambos ojos con pupiloplastia del ojo derecho, en el que se obtuvieron resultados visuales satisfactorios después de la intervención quirúrgica(AU)

ABSTRACT The iris coloboma is a congenital defect, present since birth, which is described as a hole, fissure or cleft in the mentioned structure. This condition has the possibility of being inherited or can appear without previous family history. The case is presented of a 51-year-old patient with bilateral asymmetric iris coloboma and farsightedness. The patient went to the doctor's office with the desire to become independent of his usual optical correction. Facorrefractive surgery of both eyes with pupilloplasty of the right eye was proposed, in which satisfactory visual results were obtained after the intervention(AU)