[Evaluation and follow-up in functionality in patients with Pediatric Multisystem Inflammatory Syndrome associated with COVID-19 (MIS-C)]. / Evaluación y seguimiento de funcionalidad en pacientes con Síndrome Inflamatorio Multisistémico Pediátrico asociado a COVID-19 (SIM-C).

In June 2020 appeared the first cases of Multisystem Inflammatory Syndrome in Children (MIS C) associated with COVID-19 in Chile. Possible sequelae associated with this condition are still unknown. OBJECTIVE: To describe the functional status of children with MIS-C admitted to a high complexity Hospital. PATIENTS AND METHOD: Descriptive, prospective study. Sample of 28 patients. The functional status was evaluated during Hospitalization, and in the first and fourth months after discharge with the Functional Status Scale (FSS), Pediatric Evaluation of Disability Inventory (PEDI- CAT), 6-minute walk test (6MWT), PImax and PEmax, and dynamometry. Post-Traumatic Stress Disorder was screened with the Child PTSD Symptom Scale (CPSS). RESULTS: Mean age 63.6 months. Sixteen were women and 60.7% presented no comorbidities. Half of the cases presented with Shock. Mean hospitalization was 9 days. Twenty-two patients were admitted to the ICU; 54% required me chanical ventilation and/or vasoactive drugs, and 82% had cardiac repercussions. During hospitaliza tion, 82.3% presented some physical alteration, 29.1% of them were confirmed ICU-acquired weak ness (ICU-AW), and 16.6% were suspected cases. Thirteen patients presented emotional symptoms, 39.2% had post-ICU syndrome. Most of the patients (58.8%) had an unfavorable Functional Situa tion and recovered 4 months post-discharge. All patients reversed echocardiographic abnormalities in the first month and regained muscle strength in the fourth month. 38.5% of subjects reported su boptimal values in the 6MWT and 66.6% presented alteration in the post-traumatic stress screening. CONCLUSION: Most of the patients presented functional compromise with favorable recovery despite the severity of the symptoms and possible secondary complications after ICU.

Incidence of post-anesthetic respiratory complications in pediatrics. Observational, single-center study in Medellin, Colombia / Incidencia de complicaciones respiratorias postanestésicas en pacientes pediátricos. Estudio observacional en un hospital en Medellín, Colombia

Abstract Introduction: Post-anesthetic complications, particularly respiratory complications, continue to be a source of concern due to their high frequency, particularly in pediatrics. Objective: To describe the incidence of respiratory complications in the post-anesthesia care unit of an intermediate complexity center during a six-month period, and to explore the variables associated with major respiratory complications. Materials and Methods: Retrospective cohort study based on clinical record reviews. The records of the post-anesthesia care unit of an intermediate complexity pediatric institution located in Medellin, Colombia, were reviewed. This center uses a nursing-based care model that includes patient extubation in the post-anesthesia care unit. Results: The records of 1181 patients were analyzed. The cumulative incidences of major complications were bronchospasm 1.44%, laryngospasm 0.68% and respiratory depression 0.59%. There were no cases of cardiac arrest or acute pulmonary edema. A history of respiratory infection less than 15 days before the procedure, rhinitis and female sex were associated with major respiratory complications. Conclusions: A low frequency of respiratory complications was found during care provided by nursing staff trained in anesthesia recovery and pediatric airway in the post-anesthesia care unit.

Resumen Introducción: Las complicaciones postanestésicas, especialmente las respiratorias, siguen siendo causa de preocupación por su alta frecuencia, en particular, en la población pediátrica. Objetivo: Describir la incidencia de complicaciones respiratorias en la unidad de cuidados postanestésicos de una institución de mediana complejidad, en un período de seis meses y explorar las variables relacionadas con las complicaciones respiratorias mayores. Materiales y métodos: Estudio de cohorte retrospectivo, basado en la valoración de historias clínicas. Se revisaron los registros de la unidad de cuidados postanestésicos de una institución pediátrica de mediana complejidad ubicada en Medellín. Esta institución utiliza un modelo de atención -basado en enfermería- que incluye la extubación del paciente en la unidad de cuidados postanestésicos. Resultados: Se analizaron los registros de 1181 pacientes. La incidencia acumulada de complicaciones mayores fue: broncoespasmo 1,44 %, laringoespasmo 0,68 % y depresión respiratoria 0,59 %. No se presentaron casos de paro cardiaco ni de edema agudo de pulmón. El antecedente de infección respiratoria menor a 15 días, rinitis y sexo femenino se asociaron con complicaciones respiratorias mayores. Conclusiones: Durante la atención en la unidad de cuidados postanestésicos por parte del personal de enfermería entrenado en la recuperación de la anestesia y de la vía aérea de los pacientes pediátricos, se encontró una baja frecuencia de complicaciones respiratorias.

Impaired intracellular trafficking of sodium-dependent vitamin C transporter 2 contributes to the redox imbalance in Huntington's disease.

Huntington's disease (HD) is a neurodegenerative disorder caused by a glutamine expansion at the first exon of the huntingtin gene. Huntingtin protein (Htt) is ubiquitously expressed and it is localized in several organelles, including endosomes. HD is associated with a failure in energy metabolism and oxidative damage. Ascorbic acid is a powerful antioxidant highly concentrated in the brain where it acts as a messenger, modulating neuronal metabolism. It is transported into neurons via the sodium-dependent vitamin C transporter 2 (SVCT2). During synaptic activity, ascorbic acid is released from glial reservoirs to the extracellular space, inducing an increase in SVCT2 localization at the plasma membrane. Here, we studied SVCT2 trafficking and localization in HD. SVCT2 is decreased at synaptic terminals in YAC128 male mice. Using cellular models for HD (STHdhQ7 and STHdhQ111 cells), we determined that SVCT2 trafficking through secretory and endosomal pathways is altered in resting conditions. We observed Golgi fragmentation and SVCT2/Htt-associated protein-1 mis-colocalization. Additionally, we observed altered ascorbic acid-induced calcium signaling that explains the reduced SVCT2 translocation to the plasma membrane in the presence of extracellular ascorbic acid (active conditions) described in our previous results. Therefore, SVCT2 trafficking to the plasma membrane is altered in resting and active conditions in HD, explaining the redox imbalance observed during early stages of the disease.

On the Right Track to Treat Movement Disorders: Promising Therapeutic Approaches for Parkinson's and Huntington's Disease.

Movement disorders are neurological conditions in which patients manifest a diverse range of movement impairments. Distinct structures within the basal ganglia of the brain, an area involved in movement regulation, are differentially affected for every disease. Among the most studied movement disorder conditions are Parkinson's (PD) and Huntington's disease (HD), in which the deregulation of the movement circuitry due to the loss of specific neuronal populations in basal ganglia is the underlying cause of motor symptoms. These symptoms are due to the loss principally of dopaminergic neurons of the substantia nigra (SN) par compacta and the GABAergic neurons of the striatum in PD and HD, respectively. Although these diseases were described in the 19th century, no effective treatment can slow down, reverse, or stop disease progression. Available pharmacological therapies have been focused on preventing or alleviating motor symptoms to improve the quality of life of patients, but these drugs are not able to mitigate the progressive neurodegeneration. Currently, considerable therapeutic advances have been achieved seeking a more efficacious and durable therapeutic effect. Here, we will focus on the new advances of several therapeutic approaches for PD and HD, starting with the available pharmacological treatments to alleviate the motor symptoms in both diseases. Then, we describe therapeutic strategies that aim to restore specific neuronal populations or their activity. Among the discussed strategies, the use of Neurotrophic factors (NTFs) and genetic approaches to prevent the neuronal loss in these diseases will be described. We will highlight strategies that have been evaluated in both Parkinson's and Huntington's patients, and also the ones with strong preclinical evidence. These current therapeutic techniques represent the most promising tools for the safe treatment of both diseases, specifically those aimed to avoid neuronal loss during disease progression.

Long term neurologic sequelae in a Mexican rocky mountain spotted fever case.

During the second half of the twentieth century, neurologic sequelae associated with central nervous system impairment caused by Rickettsia rickettsii were studied widely and exclusively in the United States. We present the case of a Mexican pediatric patient with neurologic sequelae 10 years after an acute infection by R. rickettsii.

Long term neurologic sequelae in a Mexican rocky mountain spotted fever case

ABSTRACT During the second half of the twentieth century, neurologic sequelae associated with central nervous system impairment caused by Rickettsia rickettsii were studied widely and exclusively in the United States. We present the case of a Mexican pediatric patient with neurologic sequelae 10 years after an acute infection by R. rickettsii.

Outside in: Unraveling the Role of Neuroinflammation in the Progression of Parkinson's Disease.

Neuroinflammation is one of the most important processes involved in the pathogenesis of Parkinson's disease (PD). The current concept of neuroinflammation comprises an inflammation process, which occurs in the central nervous system due to molecules released from brain-resident and/or blood-derived immune cells. Furthermore, the evidence of the contribution of systemic delivered molecules to the disease pathogenesis, such as the gut microbiota composition, has been increasing during the last years. Under physiological conditions, microglia and astrocytes support the well-being and well-function of the brain through diverse functions, including neurotrophic factor secretion in both intact and injured brain. On the other hand, genes that cause PD are expressed in astrocytes and microglia, shifting their neuroprotective role to a pathogenic one, contributing to disease onset and progression. In addition, growth factors are a subset of molecules that promote cellular survival, differentiation and maturation, which are critical signaling factors promoting the communication between cells, including neurons and blood-derived immune cells. We summarize the potential targeting of astrocytes and microglia and the systemic contribution of the gut microbiota in neuroinflammation process archived in PD.

Características demográficas de las madres e hijos sometidos a técnicas de reproducción asistida en el Hospital Español de México en 2016 / Demographic characteristics of mothers and children undergoing assisted reproduction techniques at Hospital Español de México in 2016

Resumen Introducción La infertilidad es una enfermedad caracterizada por la incapacidad de lograr un embarazo después de 12 meses o más de relaciones sexuales no protegidas. En México, la reproducción asistida se encuentra a la par de cualquier país, siendo la tercera nación de Latinoamérica con mayor número de centros de reproducción. Objetivo Determinar las características demográficas de las madres e hijos sometidos a técnicas de reproducción asistida (TRA) en el Hospital Español de México en 2016. Material y métodos Se trata de un estudio descriptivo, retrospectivo que incluyó a los recién nacidos producto de TRA del Hospital Español de México en 2016. Se obtuvo información sobre el método de interrupción del embarazo, el número de productos, las semanas de gestación al nacimiento, peso y talla al nacimiento y si requirieron ingreso a la UCIN, así como las complicaciones presentadas. Resultados Se incluyeron 292 pacientes sometidas a TRA. De las complicaciones maternas asociadas, las más prevalentes fueron las infecciones durante el embarazo. Se obtuvieron datos de 373 recién nacidos. Se describen las complicaciones en estos pacientes; las más frecuentes fueron las respiratorias. Conclusiones Las TRA son tratamientos cada vez más utilizados. Hay que ser cuidadosos a la hora de informar a los futuros padres acerca de las complicaciones asociadas, teniendo en cuenta la variabilidad de datos disponibles.

Abstract Introduction Infertility is a disease characterized by the inability to achieve a pregnancy after 12 months or more of unprotected sex. In Mexico, assisted reproduction is on par with any country, being the third nation in Latin America with the largest number of reproduction centers. Objective To determine the demographic characteristics of mothers and children undergoing assisted reproduction techniques (ART) at the Hospital Español de México in 2016. Material and methods This is a descriptive, retrospective study that included newborns product of ART performed in the Hospital Español de México in 2016. Information was obtained on the method of delivery, number of products, weeks of gestation at birth, birth weight and height, and if they required admission to the NICU, as well as the complications presented. Results 292 patients undergoing ART were included. Of the associated maternal complications, the most prevalent were infections during pregnancy. Data were obtained from 373 newborns. The complications in these patients are described, the most frequent being respiratory. Conclusions ART are increasingly used treatments. Care must be taken when informing prospective parents about associated complications, taking into account the variability of the available data.

Insights into the HyPer biosensor as molecular tool for monitoring cellular antioxidant capacity.

Aerobic metabolism brings inexorably the production of reactive oxygen species (ROS), which are counterbalanced by intrinsic antioxidant defenses avoiding deleterious intracellular effects. Redox balance is the resultant of metabolic functioning under environmental inputs (i.e. diet, pollution) and the activity of intrinsic antioxidant machinery. Monitoring of intracellular hydrogen peroxide has been successfully achieved by redox biosensor advent; however, to track the intrinsic disulfide bond reduction capacity represents a fundamental piece to understand better how redox homeostasis is maintained in living cells. In the present work, we compared the informative value of steady-state measurements and the kinetics of HyPer, a H2O2-sensitive fluorescent biosensor, targeted at the cytosol, mitochondrion and endoplasmic reticulum. From this set of data, biosensor signal recovery from an oxidized state raised as a suitable parameter to discriminate reducing capacity of a close environment. Biosensor recovery was pH-independent, condition demonstrated by experiments on pH-clamped cells, and sensitive to pharmacological perturbations of enzymatic disulfide reduction. Also, ten human cell lines were characterized according their H2O2-pulse responses, including their capacity to reduce disulfide bonds evaluated in terms of their migratory capacity. Finally, cellular migration experiments were conducted to study whether migratory efficiency was associated with the disulfide reduction activity. The migration efficiency of each cell type correlates with the rate of signal recovery measured from the oxidized biosensor. In addition, HyPer-expressing cells treated with N-acetyl-cysteine had accelerated recovery rates and major migratory capacities, both reversible effects upon treatment removal. Our data demonstrate that the HyPer signal recovery offers a novel methodological tool to track the cellular impact of redox active biomolecules.

A failure in energy metabolism and antioxidant uptake precede symptoms of Huntington's disease in mice.

Huntington's disease has been associated with a failure in energy metabolism and oxidative damage. Ascorbic acid is a powerful antioxidant highly concentrated in the brain where it acts as a messenger, modulating neuronal metabolism. Using an electrophysiological approach in R6/2 HD slices, we observe an abnormal ascorbic acid flux from astrocytes to neurons, which is responsible for alterations in neuronal metabolic substrate preferences. Here using striatal neurons derived from knock-in mice expressing mutant huntingtin (STHdhQ cells), we study ascorbic acid transport. When extracellular ascorbic acid concentration increases, as occurs during synaptic activity, ascorbic acid transporter 2 (SVCT2) translocates to the plasma membrane, ensuring optimal ascorbic acid uptake for neurons. In contrast, SVCT2 from cells that mimic HD symptoms (dubbed HD cells) fails to reach the plasma membrane under the same conditions. We reason that an early impairment of ascorbic acid uptake in HD neurons could lead to early metabolic failure promoting neuronal death.

Evaluation of Bacillus thuringiensis pathogenicity for a strain of the tick, Rhipicephalus microplus, resistant to chemical pesticides.

The pathogenicity of four native strains of Bacillus thuringiensis against Rhipicephalus (Boophilus) microplus (Canestrine) (Acari: Ixodidae) was evaluated. A R. microplus strain that is resistant to organophosphates, pyrethroids, and amidines, was used in this study. Adult R. microplus females were bioassayed using the immersion test of Drummond against 60 B. thuringiensis strains. Four strains, GP123, GP138, GP130, and GP140, were found to be toxic. For the immersion test, the total protein concentration for each bacterial strain was 1.25 mg/ml. Mortality, oviposition, and egg hatch were recorded. All of the bacterial strains had significant effects compared to the controls, but no significant differences were seen between the 4 strains. It is evident that these B. thuringiensis strains have a considerable detrimental effect on the R. microplus strain that is resistant to pesticides.

Lethal activity of two Bacillus thuringiensis strains against Haemonchus contortus histotropic larvae.

The in vitro lethal activity of two Bacillus thuringiensis strains (IB-16 and IB-61) against Haemonchus contortus histotropic fourth stage larvae (L(4)) was evaluated. Each B. thuringiensis strain was used as soluble proteins at different concentrations. In addition, the in vitro lethal dose (LD(50)) of each strain was determined against H. contortus L(4) at different times. Data were analyzed by ANOVA and Tukey tests. Less than 50% mortality was observed at 50 and 100 microg/mL during all bioassays. More than 50% mortality was observed at 200 microg/mL at 3 and 5 days after interaction with IB-16 and IB-61, respectively. A 100% mortality was observed with IB-16 on day 5. The LD(50) with IB-16 was 248 microg/mL on day 3, and IB-61 showed an LD(50) at 227 microg/mL on the day 5. Both toxins may have potential as biocontrol agents.