Frequency of Spinal Segmental Sensitization Syndrome and Associated Social Determinants of Health.

OBJECTIVE: To determine the frequency of spinal segmental sensitization (SSS) syndrome and its association with socioeconomic and educational levels, Depression, smoking, and alcoholism. DESIGN: Analytic cross-sectional study conducted within the time frame of February-August 2022. SETTING: Outpatient consultation area of the Hospital Regional Universitario de Colima, a public health care institution in Mexico PARTICIPANTS: Ninety-eight patients over 18 years of age were selected that presented with chronic musculoskeletal pain of at least 3-month progression (N=98). The patients were initially selected through simple random sampling, complementing 60% of the calculated sample with consecutive cases due to the pandemic status. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE(S): The subjects gave their informed consent, authorizing the clinical history interview and physical examination that applied the 2019 diagnostic criteria of Nakazato and Romero, as well as the AMAI test, the Mexican National Education System, the Beck Depression Inventory, Fagerstrom Test, and Alcohol Use Disorders Identification Test instrument, to collect the data on socioeconomic and educational levels, Depression, smoking, and alcoholism, respectively. Frequencies and percentages were obtained for the statistical analysis, using the chi-square test, multiple logistic regression, and bivariate/multivariate analyses with the prevalence odds ratio. RESULTS: SSS had a 22.4% frequency and was significantly associated (P<.05) with moderate Depression and severe Depression, signifying that a patient with moderate depression had 5.57 times more probability of presenting with SSS (95% CI, 1.27-30.16, P<.05), whereas a patient with severe Depression had 8.68 times more probability of presenting with SSS (95% CI, 1.99-47.77, P<.05). The results of the remaining variables were not statistically significant. CONCLUSIONS: There is a need for a biopsychosocial focus on SSS, in which the detection of and approach to moderate and severe Depression favors patient awareness of aspects associated with the phenomenon of chronic pain and the creation of coping strategies for that pain.

Study of Liquid-Based Cytology Using Next-Generation Sequencing as a Liquid Biopsy Application in Patients with Advanced Oncological Disease.

In patients with advanced cancer, it is necessary to detect driver mutations and genetic arrangements. If a mutation is found, targeted therapy may become an option. However, in most patients with advanced cancer, obtaining material can be challenging, and these determinations must be made based on small biopsies or cytologic samples. We analyzed the ability of liquid-based cytology to determine the mutational status in patients with advanced cancer by next-generation sequencing. We studied cytologic samples from 28 patients between 1 January 2018 and 31 December 2022. All samples were processed by next-generation sequencing using the Oncomine® Precision and Comprehensive Assay Panels for Solid Tumors. Eleven male and 17 female patients with a median age of 63.75 years were included. Clinical stage IV was predominant in 21 patients. Eleven patients died, and 17 survived. The DNA and RNA concentrations were 10.53 ng/µL and 13 ng/µL, respectively. Eleven patients showed actionable mutations, and 17 showed other genomic alterations. Liquid-based cytology can be used as a component of liquid biopsy, as it allows the identification of actionable mutations in patients with advanced oncological disease. Our findings expand the utility of liquid biopsy from different body fluids or cell aspirates.

Self-efficacy, organizational commitment, workload as predictors of life satisfaction in elementary school teachers: the mediating role of job satisfaction.

Background: Life satisfaction as well as job satisfaction of teachers has a significant impact on educational outcomes. Objective: To evaluate a model of factors predicting life satisfaction through the mediating role of job satisfaction. Methods: This was a cross-sectional study, with a sample of 300 primary school teachers of both sexes (68% female, 32% male) and with a mean age of 42.52 years (SD = 10.04). They were administered the General Self-Efficacy Scale, the Satisfaction with Life Scale (SWLS), the Workload Scale (ECT), the Generic Job Satisfaction Scale, and the Organizational Commitment Questionnaire (OCQ). Structural equation modeling (SEM) was used for data analysis. Results: The SEM analysis found significant goodness-of-fit indices: (χ2 = 13.739; df = 5; p = <0.001; CFI = 0.99, TLI = 0.98, RMSEA = 0.05, SRMR = 0.04). Specifically, self-efficacy and organizational commitment were positive predictors of job satisfaction, while workload was a negative predictor of job satisfaction. The mediating effect of job satisfaction between self-efficacy, life satisfaction, workload, and overall life satisfaction was confirmed. Conclusion: The results confirm the importance of self-efficacy, organizational commitment, and workload in job satisfaction and overall life satisfaction of elementary education teachers. Job satisfaction acts as a mediator in this relationship. It is important to reduce workload and promote self-efficacy and organizational commitment to improve the well-being and satisfaction of teachers.

Índice neutrófilo/linfocito en anestesia general con ventilación controlada por volumen versus ventilación controlada por presión: ensayo clínico aleatorizado / Neutrophil/lymphocyte ratio in general anesthesia with volume-controlled ventilation versus pressure-controlled ventilation: a randomized clinical trial

Resumen: Introducción: se ha demostrado que la ventilación mecánica induce la producción de citocinas proinflamatorias. El IN/L es un parámetro sencillo que se utiliza para evaluar el estado inflamatorio. Objetivo: comparar los promedios y porcentajes del índice neutrófilo/linfocito (IN/L) elevado, entre pacientes con anestesia general con ventilación mecánica controlada por volumen (VMCV) y ventilación mecánica controlada por presión (VMCP). Material y métodos: se seleccionaron adultos ≥ 18 años, ASA I-III con cirugía electiva y anestesia general. Ensayo clínico aleatorizado: 25 pacientes con VMCV y 25 con VMCP. A todos los pacientes se les determinó dos biometrías hemáticas: antes y 2 horas después de la cirugía. El IN/L fue medido en forma de razón y dicotómica (< 3 o ≥ 3). Análisis estadístico: se utilizaron las pruebas t de Student, χ2 y McNemar. Resultados: se estudiaron 50 pacientes (27 mujeres y 23 hombres) con un promedio de edad de 47 ± 16 años. El grupo de VMCV tuvo tendencia a presentar valores más bajos de promedios y porcentajes IN/L; sin embargo, no fue estadísticamente significativa (p = 0.06). En la comparación pareada ambos grupos presentaron incremento estadísticamente significativo de los promedios y porcentajes de IN/L. No obstante, el porcentaje de IN/L > 3 en el grupo de VMCP fue de 64%, mientras que en el grupo de VMCV fue de 40%. Conclusiones: la VMCV presenta promedios y porcentajes más bajos del IN/L comparados con VMCP; sin embargo, no fueron estadísticamente significativos.

Abstract: Introduction: it has been shown that mechanical ventilation induces production of proinflammatory cytokines. The Neutrophil-to-lymphocyte ratio (N/L r) is a simple parameter that is used to assess the inflammatory state. Objective: to compare the means and percentages of elevated neutrophil/lymphocyte ratio (N/L r) in patients under general anesthesia with volume-controlled mechanical ventilation (VCMV) and pressure-controlled mechanical ventilation (PCMV). Material and methods: adults ≥ 18 years old, ASA I-III, with elective surgery and general anesthesia. Randomized clinical trial: 25 patients with VCMV and 25 with PCMV. All patients had two blood counts determined: before and 2 hours after surgery. N/L r was measured as a ratio and dichotomous (< 3 or ≥ 3). Statistical analysis: the t-Student, χ2 and McNemar tests were used. Results: 50 patients (27 women and 23 men) with a mean age of 47 ± 16 years (range 18-84 years) were studied. The VCMV group tended to present lower values of means and percentages N/L r, however, it was not statistically significant (p = 0.06). In the paired comparison, both groups presented a statistically significant increase in the means and percentages of N/L r. However, the percentage of N/L r > 3 in the PCMV group was 64%, while in the VCMV group it was 40%. Conclusions: the VCMV presents lower means and percentages of N/L r compared to PCMV, however, they were not statistically significant.

Blood Liquid Biopsy in an Advanced Medullary Thyroid Carcinoma: A Case Study with Rearranged during Transfection Heterogeneity.

INTRODUCTION: Liquid biopsy is an innovative and efficient method for studying circulating tumor DNA. In conjunction with innovative techniques such as next-generation sequencing, it can provide real-time information on prognostic and predictive factors. CASE PRESENTATION: We report a case of advanced, unresectable medullary thyroid carcinoma with various rearranged during transfection (RET) and Kirsten rat sarcoma viral (KRAS) mutations in both blood liquid and tissue biopsies. After the initial failure of treatment with a tyrosine kinase inhibitor (TKI), a liquid biopsy analyzed by next-generation sequencing showed the presence of six different RET mutations and KRAS. Tissue biopsy also revealed two RET mutations. Due to these biopsy findings, the treatment was changed to another TKI, and the patient is now clinically stable. DISCUSSION/CONCLUSION: Liquid biopsy makes it possible to analyze different genetic alterations that may have implications as predictive factors. It also reveals tumor heterogeneity and its implications for prognostic factors.

SARS-CoV-2 Serum Viral Load and Prognostic Markers Proposal for COVID-19 Pneumonia in Low-Dose Radiation Therapy Treated Patients.

Several studies have shown that the plasma RNA of SARS-CoV-2 seems to be associated with a worse prognosis of COVID-19. In the present study, we investigated plasma RNA in COVID-19 patients treated with low-dose radiotherapy to determine its prognostic value. Data were collected from the IPACOVID prospective clinical trial (NCT04380818). The study included 46 patients with COVID-19 pneumonia treated with a whole-lung dose of 0.5 Gy. Clinical follow-up, as well as laboratory variables, and SARS-CoV-2 serum viral load, were analyzed before LDRT, at 24 h, and one week after treatment. The mean age of the patients was 85 years, and none received any of the SARS-CoV-2 vaccine doses. The mortality ratio during the course of treatment was 33%. RT-qPCR showed amplification in 23 patients. Higher mortality rate was associated with detectable viremia. Additionally, C-reactive protein, lactate dehydrogenase, and aspartate aminotransferase were significant risk factors associated with COVID-19 mortality. Our present findings show that detectable SARS-CoV-2 plasma viremia 24 h before LDRT is significantly associated with increased mortality rates post-treatment, thus downsizing the treatment success.

Utility of ctDNA Liquid Biopsies from Cancer Patients: An Institutional Study of 285 ctDNA Samples.

Liquid biopsy has improved significantly over the last decade and is attracting attention as a tool that can complement tissue biopsy to evaluate the genetic landscape of solid tumors. In the present study, we evaluated the usefulness of liquid biopsy in daily oncology practice in different clinical contexts. We studied ctDNA and tissue biopsy to investigate EGFR, KRAS, NRAS, and BRAF mutations from 199 cancer patients between January 2016 and March 2021. The study included 114 male and 85 female patients with a median age of 68 years. A total of 122 cases were lung carcinoma, 53 were colorectal carcinoma, and 24 were melanoma. Liquid biopsy was positive for a potentially druggable driver mutation in 14 lung and colorectal carcinoma where tissue biopsy was not performed, and in two (3%) lung carcinoma patients whose tissue biopsy was negative. Liquid biopsy identified nine (45%) de novo EGFR-T790M mutations during TKI-treatment follow-up in lung carcinoma. BRAF-V600 mutation resurgence was detected in three (12.5%) melanoma patients during follow-up. Our results confirm the value of liquid biopsy in routine clinical oncologic practice for targeted therapy, diagnosis of resistance to treatment, and cancer follow-up.

Immunohistochemical Algorithm for the Classification of Muscle-Invasive Urinary Bladder Carcinoma with Lymph Node Metastasis: An Institutional Study.

Muscle-invasive urothelial carcinoma represents 20% of newly diagnosed cases of bladder cancer, and most cases show aggressive biological behavior with a poor prognosis. It is necessary to identify biomarkers that can be used as prognostic and predictive factors in daily clinical practice. In our study, we analyzed different antibodies in selected cases of muscle-invasive urinary bladder carcinoma and lymph node metastasis to identify immunohistochemical types and their value as possible prognostic factors. A total of 38 patients were included, 87% men and 13% women, with a mean age of 67.8 years. The most frequent histopathological type was urothelial carcinoma. In the primary lesion, the mixed type was the most common. In unilateral metastasis, the mixed type was the most frequently found. In cases of primary lesions and bilateral metastasis, the luminal and mixed types were observed. The luminal subtype was the most stable in immunohistochemical expression across primary tumors and metastases. The basal type showed a better prognosis in terms of disease-free survival. In conclusion, immunohistochemical studies are useful in assessing primary and metastatic lesions in patients with urothelial carcinoma. Immunohistochemical classification can typify muscle-invasive urothelial carcinoma, and the immunophenotype seems to have prognostic implications.

Componentes de fragilidad, sarcopenia y su asociación con insuficiencia de vitamina D. Estudio transversal analítico / Components of frailty, sarcopenia and their association with vitamin D deficiency. Cross-sectional, analytical study

Resumen Introducción: En adultos mayores, la asociación de fragilidad y sarcopenia con deficiencia de vitamina D es conocida, pero poco se ha estudiado la asociación de los componentes del síndrome de fragilidad. Objetivo: Determinar la asociación entre los componentes de fragilidad, sarcopenia e insuficiencia de vitamina D en adultos mayores. Métodos: Se estudiaron adultos de quienes se registró edad, escolaridad, estado civil, antecedentes de fracturas, hospitalizaciones, indicadores antropométricos, sarcopenia, índice de Charlson, polifarmacia, fenotipo de fragilidad de Fried y vitamina D plasmática; cifras < 30 ng/mL se consideraron indicativas de insuficiencia de vitamina D. Para el análisis estadístico se utilizó estadística descriptiva e inferencial. La asociación fue determinada mediante regresión logística binaria. Resultados: Se estudiaron 175 adultos con un promedio de edad de 71.7 ± 6.7 años (IC 95 % = 60-90 años). La regresión logística binaria demostró que las variables asociadas a insuficiencia de vitamina D fueron agotamiento (RM = 2.6, IC 95 % = 1.0-6.5, p = 0.03), fragilidad (RM = 9.2, IC 95 % = 2.5-34.1, p = 0.001) y prefragilidad (RM = 4.6, IC 95 % = 2.1-10.0, p < 0.001). Conclusión: Los fenotipos frágil, prefrágil y agotamiento se asocian a insuficiencia de vitamina D.

Abstract Introduction: In older adults, the association of frailty and sarcopenia with vitamin D deficiency is well known, but the association of the components of frailty syndrome has been poorly studied Objective: To determine the association of the components of frailty and sarcopenia with vitamin D insufficiency in older adults. Methods: Adults were studied, in whom age, education, marital status, history of fractures, hospitalizations, anthropometric indicators, sarcopenia, Charlson index, polypharmacy, Fried's frailty phenotype, and plasma vitamin D were recorded; figures < 30 ng/mL were considered indicative of vitamin D insufficiency. Descriptive and inferential statistics were used for statistical analysis. The association was determined by binary logistic regression. Results: One-hundred and seventy-five adults with a mean age of 71.7 ± 6.7 years (95% CI = 60-90 years) were studied. Binary logistic regression showed that the variables associated with vitamin D deficiency were exhaustion (OR = 2.6, 95% CI = 1.0-6.5, p = 0.03), frailty (OR = 9.2, 95% CI = 2.5-34.1, p = 0.001) and pre-frailty (OR = 4.6, 95% CI = 2.1-10.0, p < 0.001). Conclusion: The frail and pre-frail phenotypes, as well as exhaustion, are associated with vitamin D insufficiency.

2.1 Å crystal structure of the Mycobacterium tuberculosis serine hydrolase, Hip1, in its anhydro-form (Anhydrohip1).

The 2.6 Å crystal structure of the apo form of Hip1 (hydrolase important for pathogenesis) has been previously reported. However, very little is known about the active site architecture of this M. tuberculosis (Mtb), serine hydrolase drug target. To begin mapping the active site of Hip1, we cocrystallized Hip1 with the irreversible serine protease inhibitor, 4-(2-aminoethyl)-benzenesulfonylfluoride (AEBSF). We chose AEBSF for cocrystallization with Hip1 since the similar inhibitor, phenylmethylsulfonyl fluoride (PMSF), interestingly exhibited no activity against Hip1. We obtained crystals that diffracted to 2.1 Å but to our bewilderment, we did not observe any electron density for the inhibitor in the omit map for the Hip1-AEBSF complex. Rather, in the active site, dehydroalanine (dAla) was found to occupy the expected position of the catalytic Ser228, thus yielding anhydrohip1. Here we present a comparative analysis of the crystal structures of anhydrohip1 and Hip1 and provide a mechanism for the conversion of the enzyme to the anhydro-form through reaction with AEBSF. With the aid of molecular docking, we propose an explanation for the differential inhibition of Hip1 by AEBSF and PMSF. We also present a preliminary definition of the S1 and S2 pockets of the protease's active site and propose a mechanism for a ligand-induced conformational change within the S2 pocket. Finally, we expand upon the previous demarcation of the putative lipid binding pocket in the α-domain of the enzyme. We believe that this detailed analysis of the structures of anhydrohip1 and Hip1 provides valuable information useful for the structure-based drug design of novel Hip1-directed Mtb therapeutics.

Usefulness of the Urine Methylation Test (Bladder EpiCheck®) in Follow-Up Patients with Non-Muscle Invasive Bladder Cancer and Cytological Diagnosis of Atypical Urothelial Cells-An Institutional Study.

Urothelial bladder cancer is a heterogeneous disease and one of the most common cancers worldwide. Bladder cancer ranges from low-grade tumors that recur and require long-term invasive surveillance to high-grade tumors with high mortality. After the initial contemporary treatment in non-muscle invasive bladder cancer, recurrence and progression rates remain high. Follow-up of these patients involves the use of cystoscopies, cytology, and imaging of the upper urinary tract in selected patients. However, in this context, both cystoscopy and cytology have limitations. In the follow-up of bladder cancer, the finding of urothelial cells with abnormal cytological characteristics is common. The main objective of our study was to evaluate the usefulness of a urine DNA methylation test in patients with urothelial bladder cancer under follow-up and a cytological finding of urothelial cell atypia. In addition, we analyzed the relationship between the urine DNA methylation test, urine cytology, and subsequent cystoscopy study. It was a prospective and descriptive cohort study conducted on patients presenting with non-muscle invasive urothelial carcinoma between 1 January 2018 and 31 May 2022. A voided urine sample and a DNA methylation test was extracted from each patient. A total of 70 patients, 58 male and 12 female, with a median age of 70.03 years were studied. High-grade urothelial carcinoma was the main histopathological diagnosis. Of the cytologies, 41.46% were cataloged as atypical urothelial cells. The DNA methylation test was positive in 17 urine samples, 51 were negative and 2 were invalid. We demonstrated the usefulness of a DNA methylation test in the follow-up of patients diagnosed with urothelial carcinoma. The methylation test also helps to diagnose urothelial cell atypia.

Immunocytochemical Assessment of ACE2 and TMPRSS2 in Nasopharyngeal Swabs from SARS-CoV-2 Patients.

BACKGROUND: SARS-CoV-2 is a positive-sense single-stranded RNA virus. It is enveloped by four structural proteins. The entry of the virus into the host cells is mediated by spike protein binding to the angiotensin converting enzyme 2 (ACE2) and proteolytic cleavage by transmembrane protease serine 2 (TMPRSS2). In this study, we analyzed the expression of the ACE2 receptor and TMPRSS2 in cases under investigation for SARS-CoV-2 infection. METHODS: The study was carried out using the viral transport medium of consecutive nasopharyngeal swabs from 300 people under examination for SARS-CoV-2 infection. All samples underwent the SARS-CoV-2 transcriptase-mediated amplification assay (Procleix® SARS-CoV-2) to detect the virus. Immunocytochemistry was used in each sample to detect the presence of the SARS-CoV-2 nucleoprotein, the ACE2 receptor, and TMPRSS2. RESULTS: An immunocytochemical study with monoclonal antibody against SARS-CoV-2 viral nucleoprotein showed positivity in squamous cells. ACE2 were not detected in the squamous cells obtained from the nasopharyngeal samples. CONCLUSIONS: SARS-CoV-2 predominantly localizes to squamous cells in cytology samples of patients with positive transcriptase-mediated amplification SARS-CoV-2 assay results. The immunocytochemical negativity for ACE2 evidenced in the present study could be related to the cellular heterogeneity present in the nasopharyngeal smear samples and could be related to variations at the genomic level. Our results suggest that SARS-CoV-2 might be present in the nasopharyngeal region because viral cell junctions are weaker. This facilitates viral concentration, infective capacity and migration to specific organs, where SARS-CoV-2 infects target cells by binding to their receptors and then entering.

Cirugías ablativas por causas oncológicas. 17 años de experiencia en una Unidad Especializada del Estado Monagas, Venezuela / Ablative surgeries for oncological causes. 17 years experience in a Monagas specialized unit

Estudio retrospectivo, sobre pacientes a quienes se les practicó cirugías ablativas por causas oncológicas: un total de 76 casos, predominando en la serie: el sexo masculino, la segunda década de la vida y como motivo de consulta: aumento de volumen con un 73,5%, el osteosarcoma fue la neoplasia más frecuente con un 34%, la fractura patológica acompañó a los tumores en el 50% de los casos, el hueso más afectado fue el fémur, los estadios según Enneking predominantes fueron los II b y III. Se practicaron más cirugías en miembros inferiores, siendo la amputación transfemoral la más frecuente. La intención de los procedimientos fue predominantemente curativa con un 69% sobre las intenciones paliativas, se practicaron más amputaciones en niveles oncológicos radicales que amplias. Se obtuvo una sobrevida global de 53,4% a los dos años de seguimiento, el miembro fantasma estuvo presente como complicación por encima del 77% de los casos operados(AU)

Retrospective study on patients who underwent ablative surgeries for oncological causes: a total of 76 cases, predominantly in the series: male sex, second decade of life and as a reason for consultation: volume increase with 73,5%. Osteosarcoma was the most frequent neoplasm with 34%, pathological fracture accompanied the tumors in 50% of cases, the most affected bone was the femur, the predominant Enneking stages were IIb and III. More surgeries were performed on the lower limbs, with transfemoral amputation being the most frequent. The intention of the procedures was predominantly curative with 69% of the palliative intentions, more amputations were performed at radical oncological levels than extensive ones. An overall survival of 53.4% was obtained at two years of follow-up, the phantom limb was present as a complication in over 77% of operated cases.

Impact on the Nutritional and Functional Status of Older Mexican Adults in the Absence of Recreational Activities due to COVID-19: A Longitudinal Study From 2018 to 2021.

A longitudinal study, from 2018 to 2021, identified impacts on the nutritional and functional status of older adults when face-to-face activities at a social assistance center in Mexico were suspended due to the COVID-19 pandemic. A total of 71 older adults were evaluated at three different periods: 18 months prior, three months before the pandemic, and 12 months after the onset of the pandemic. Seventy-one older adults completed follow up. Anthropometric measurements, dietary intake, physical tests, and health screening for malnutrition, dependence, and physical frailty, were evaluated. There was a significant decrease in lean body mass and body water in the older adults assessed, in addition to a significant reduction in the frailty scale and gait speed. Finally, a significant reduction in ingested energy and several nutrients such as protein, and carbohydrates, was found, yet an increase in sugar and cholesterol intake was noted.

Components of frailty, sarcopenia and their association with vitamin D deficiency. Cross-sectional, analytical study.

INTRODUCTION: In older adults, the association of frailty and sarcopenia with vitamin D deficiency is well known, but the association of the components of frailty syndrome has been poorly studied. OBJECTIVE: To determine the association of the components of frailty and sarcopenia with vitamin D insufficiency in older adults. METHODS: Adults were studied, in whom age, education, marital status, history of fractures, hospitalizations, anthropometric indicators, sarcopenia, Charlson index, polypharmacy, Fried's frailty phenotype, and plasma vitamin D were recorded; figures < 30 ng/mL were considered indicative of vitamin D insufficiency. Descriptive and inferential statistics were used for statistical analysis. The association was determined by binary logistic regression. RESULTS: One-hundred and seventy-five adults with a mean age of 71.7 ± 6.7 years (95% CI = 60-90 years) were studied. Binary logistic regression showed that the variables associated with vitamin D deficiency were exhaustion (OR = 2.6, 95% CI = 1.0-6.5, p = 0.03), frailty (OR = 9.2, 95% CI = 2.5-34.1, p = 0.001) and pre-frailty (OR = 4.6, 95% CI = 2.1-10.0, p < 0.001). CONCLUSION: The frail and pre-frail phenotypes, as well as exhaustion, are associated with vitamin D insufficiency.

INTRODUCCIÓN: En adultos mayores, la asociación de fragilidad y sarcopenia con deficiencia de vitamina D es conocida, pero poco se ha estudiado la asociación de los componentes del síndrome de fragilidad. OBJETIVO: Determinar la asociación entre los componentes de fragilidad, sarcopenia e insuficiencia de vitamina D en adultos mayores. MÉTODOS: Se estudiaron adultos de quienes se registró edad, escolaridad, estado civil, antecedentes de fracturas, hospitalizaciones, indicadores antropométricos, sarcopenia, índice de Charlson, polifarmacia, fenotipo de fragilidad de Fried y vitamina D plasmática; cifras < 30 ng/mL se consideraron indicativas de insuficiencia de vitamina D. Para el análisis estadístico se utilizó estadística descriptiva e inferencial. La asociación fue determinada mediante regresión logística binaria. RESULTADOS: Se estudiaron 175 adultos con un promedio de edad de 71.7 ± 6.7 años (IC 95 % = 60-90 años). La regresión logística binaria demostró que las variables asociadas a insuficiencia de vitamina D fueron agotamiento (RM = 2.6, IC 95 % = 1.0-6.5, p = 0.03), fragilidad (RM = 9.2, IC 95 % = 2.5-34.1, p = 0.001) y prefragilidad (RM = 4.6, IC 95 % = 2.1-10.0, p < 0.001). CONCLUSIÓN: Los fenotipos frágil, prefrágil y agotamiento se asocian a insuficiencia de vitamina D.

Study of the Plasma and Buffy Coat in Patients with SARS-CoV-2 Infection-A Preliminary Report.

The pandemic caused by the SARS-CoV-2 infection affects many aspects of public health knowledge, science, and practice around the world. Several studies have shown that SARS-CoV-2 RNA in plasma seems to be associated with a worse prognosis of COVID-19. In the present study, we investigated plasma and buffy RNA in patients with COVID-19 to determine its prognostic value. A prospective study was carried out in patients hospitalized for COVID-19, in which RNA was analyzed in plasma and the buffy coat. Morphological and immunohistochemical studies were used to detect the presence of SARS-CoV-2 in the buffy coat. In COVID-19 patients, the obtained RNA concentration in plasma was 448.3 ± 31.30 ng/mL. Of all the patients with positive plasma tests for SARS-CoV-2, 46.15% died from COVID-19. In four cases, tests revealed that SARS-CoV-2 was present in the buffy coat. Abnormal morphology of monocytes, lymphocytes and neutrophils was found. An immunohistochemical study showed positivity in mononuclear cells and platelets. Our results suggest that SARS-CoV-2 is present in the plasma. This facilitates viral dissemination and migration to specific organs, where SARS-CoV-2 infects target cells by binding to their receptors. In our study, the presence of plasma SARS-CoV-2 RNA was correlated with worse prognoses.

Messages from university teachers to their students with low academic performance during online teaching necessitated by COVID-19 / Mensajes emitidos por docentes universitarios a sus estudiantes con bajos desempeños académicos durante la enseñanza en línea por COVID-19

Abstract COVID-19 generated new forms of student-teacher interactions, and it increased the use of virtual educational environments. Electronic messaging is one of the most widely used forms of communication between teachers and students. However, few studies on how teachers provide feedback motivate and encourage students to engage in academic activities in online learning environments. This study aims to characterize messages sent by university teachers to their students with low academic performance during the emergency remote teaching in the COVID-19 pandemic context. The electronic messages were obtained through the snowball sampling technique. The sample consisted of eighteen email threads facilitated by six universities. Ethical requirements for this type of research were met, and discourse or text analysis was used as a methodology with a qualitative approach and hermeneutic orientation. This study shows two main results. First, the necessary data to identify students with low academic performance can be mainly obtained from their teachers and third parties, like university authorities. Second, there are a number of elements to consider when creating messages to improve the engagement of underperforming students. These fundamental elements are: tone of voice, content of the message and moment in which the message is sent. Messages that are explicitly written for each student or group of students and messages that were written with anticipation, showed to be most effective in engaging students.

Resumen La COVID-19 generó nuevas formas de interacción estudiante-profesor e incrementó el uso de ambientes educativos virtuales, siendo la mensajería electrónica uno de las más utilizados para la comunicación en las relaciones entre ellos. En este contexto, el modo en que comunica el docente y los mensajes que emite, impactan en variables académicas de estudiantes, sobre todo en estudiantes que tienen bajos desempeños académicos. En la actualidad son escasos los estudios sobre la manera en que el docente retroalimenta, motiva e impulsa al estudiante a involucrarse en actividades académicas en los entornos de aprendizaje en línea; por tanto, el objetivo de esta investigación fue caracterizar mensajes emitidos por docentes universitarios a sus estudiantes con bajos desempeños académicos durante la enseñanza en línea por COVID-19. Se utilizó el análisis del discurso o de texto como método con enfoque cualitativo y orientación hermenéutica para caracterizar los mensajes, considerando el sentido y significado de estos, lo cual permitió rescatar la riqueza de los mensajes y analizarlos, en particular aquellos que lograron alguna respuesta de compromiso por parte de los estudiantes. Los mensajes de correo electrónico se obtuvieron a través de un muestreo no probabilístico mediante la técnica de bola de nieve. La muestra estuvo constituida por 18 cadenas de mensajes de correo, facilitados por seis universidades, que fueron emitidos durante la enseñanza en línea por COVID-19. Se cumplieron con los requerimientos éticos para este tipo de investigación. El análisis de los datos se realizó a través de tres grandes pasos: (1) revisión de la información; (2) identificación de las unidades de análisis, y (3) categorización. Dentro de los principales resultados se encuentran: (1) docentes y terceras personas (autoridades) son las fuentes de información que permiten identificar a estudiantes con bajos desempeños académicos; (2) los mensajes que utilizan los profesores para comunicarse con sus estudiantes poseen especificaciones en el tono comunicacional, contenido y momento de la comunicación que favorecen el compromiso de aquellos estudiantes que presentan bajos desempeños académicos, siendo los mensajes personalizados, anticipados y con alternativas propositivas los más efectivos, y (3) los mensajes emitidos por docentes que favorecen algún tipo de compromiso de los estudiantes son los que: utilizan un tono comunicacional personal, presentan contenido de preocupación y/o de aliento, comunican tempranamente evidencias de incumplimientos que permiten la detección, y ofrecen alternativas concretas que puede utilizar el/la estudiante para revertir la situación de incumplimiento o bajo desempeño. Además, se pudo observar que los profesores, en la comunicación con sus estudiantes, utilizan con frecuencia contenidos, evidencias y mensajes instructivos, y la razón fundamental que emplean en el mensaje es la ausencia de registro de alguna calificación. La mayoría de los docentes que participaron de este estudio envían los mensajes cuando aún les resulta posible ofrecer oportunidades al estudiante para revertir su situación académica, con frecuencia utilizan un tono de comunicación personal y el de tercera persona (impersonal), por sobre el tono institucional. Se entregan orientaciones para el diseño de mensajes electrónicos más efectivos que permitan revertir situaciones de desempeño insatisfactorio. Se concluye que para comunicarse con los estudiantes es importante diseñar mensajes con características específicas que los hagan más efectivos.

Professors' Expectations About Online Education and Its Relationship With Characteristics of University Entrance and Students' Academic Performance During the COVID-19 Pandemic.

Due to COVID-19, universities have been facing challenges in generating the best possible experience for students with online academic training programs. To analyze professors' expectations about online education and relate them to student academic performance during the COVID-19 pandemic, and considering the socio-demographic, entry, and prior university performance variables of students. A prospective longitudinal design was used to analyze the expectations of 546 professors (54.8% male) in T1. In T2, the impact of the expectations of 382 of these professors (57.6% men) was analyzed, who taught courses during the first semester to a total of 14,838 university students (44.6% men). Professors' expectations and their previous experience of online courses were obtained during T1, and the students' academic information was obtained in T2. A questionnaire examining the Expectations toward Virtual Education in Higher Education for Professors was used. 84.9% of the professors were considered to have moderate to high skills for online courses. Differences in expectations were found according to the professors' training level. The professors' self-efficacy for online education, institutional engagement, and academic planning had the highest scores. The expectations of professors did not directly change the academic performance of students; however, a moderating effect of professor's expectations was identified in the previous student academic performance relationship on their current academic performance.

Total Tumor Load of mRNA Cytokeratin 19 in the Sentinel Lymph Node as a Predictive Value of Axillary Lymphadenectomy in Patients with Neoadjuvant Breast Cancer.

Although sentinel lymph node biopsy (SLNB) has proved to be able to diagnose axillary lymph node status safely and reliably, there is still not enough evidence to suggest that it can be used in patients who have undergone neoadjuvant chemotherapy (NAC) for lymph node-sparing surgery. The present study used molecular approaches to determine whether SLNB can be reliably used in patients who have been treated with NAC before SLN surgery, and whether the total tumor load of the SLN can be used as a predictive factor in axillary lymphadenectomy (ALD). We used one-step nucleic acid amplification (OSNA) to analyze a total of 111 consecutive patients who presented operable invasive breast carcinomas and who had been treated with NAC. SLN was positive in 55 patients and the identification rate was 100%. In 9 of these 55 patients, ALD showed that other lymph nodes were also involved. In all of the other 46 patients, the only lymph node to be identified as positive was SLN. Metastasis was not found in any of the axillary lymph nodes in the isolated tumor cell group. The total tumor load, defined as the amount of cytokeratin 19 mRNA copy numbers in all positives SLN (copies/µL), showed three risk groups related to the possibility of positive non-sentinel nodes. OSNA is a diagnostic technique that is highly sensitive, specific, and reproducible and it can be used to analyze sentinel lymph nodes after NAC. Total tumor load may be able to help predict additional metastases in axillary lymphadenectomy.

Liquid-based cytological and immunohistochemical study of nasopharyngeal swab from persons under investigation for SARS-CoV-2 infection.

INTRODUCTION: We describe cytologic and immunohistologic findings in virus transport medium on cases under investigation of SARS-CoV-2 infection. METHODS: Cytologic findings in cases under investigation of SARS-CoV-2 infection from one hundred consecutive nasopharyngeal swab were reviewed. Immunohistochemistry and SARSCoV-2 RT-PCR determination were performed to detect virus. RESULTS: No viral inclusions were noted in squamous cells obtained from virus transport medium. Immunohistochemical study with monoclonal antibody against SARS-CoV-2 viral nucleoprotein showed positivity in squamous cells. No positivity was present in others cellular components. CONCLUSIONS: SARS-CoV-2 predominantly localizes squamous cells in cytology samples of patients with RT-PCR positive determination of SARSCoV-2. The results of the current study support the notion that the nasopharyngeal region is the anatomical station that SARS-CoV-2 infects first, and the infection can lead to the migration of the virus into the lower airways.