Sentinel lymph node mapping with indocyanine green using SPY-PHI in open radical hysterectomy or trachelectomy.

OBJECTIVE: To evaluate the detection rate of at least one sentinel lymph node (SLN) in patients with early cervical cancer who underwent open radical hysterectomy or trachelectomy using indocyanine green (ICG) with the SPY Portable Handler Imager (SPY-PHI) system. METHODS: We retrospectively reviewed patients with cervical cancer FIGO 2018 stage IA1 with lymphovascular invasion up to stage IIIC1p who underwent SLN mapping and open radical hysterectomy or trachelectomy from March 2018 through August 2022 at The University of Texas MD Anderson Cancer Center. ICG was the only tracer used with the SPY-PHI system. Patient demographics, surgical approach, and tumor factors were analyzed. Overall detection, bilateral detection, and empty lymph node packet rates were determined. RESULTS: A total of 106 patients were included. Ninety-four (88.7%) patients underwent open radical hysterectomy and 12 (11.3%) open radical trachelectomy. Median age was 40 years (range, 23-71). Median body mass index was 28.8 kg/m2 (range, 17.6-48.4). The most common FIGO 2018 stages were IB1 (35%) and IB2 (30%). The most common histologic subtypes were squamous cell carcinoma (45%) and adenocarcinoma (45%). Most patients had grade 2 disease (61%) and no lymphovascular invasion (58%). Median tumor size was 1.8 cm (range, 0.3-4). Median number of detected SLN was 4 (range, 0-12). An SLN was identified during surgery in 104 patients (98%), with bilateral mapping in 94 (89%) and unilateral mapping in 10 (9%). The empty lymph node packet rate was 4 (3.8%). The external iliac (73%) was the most common site of SLN detection. Fourteen patients had positive lymph nodes (13.5%); 3 (21.4%) had macrometastases, 9 (64.3%) had micrometastases, and 2 (14.3%) had isolated tumor cells. CONCLUSION: SLN mapping using ICG with the SPY-PHI system in open radical hysterectomy or trachelectomy is reliable and results in high overall and bilateral detection rates in patients with early cervical cancer.

Kinetics of the in vivo genotoxic and radioprotective effects of methyl gallate and epigallocatechin gallate.

The aim of this study was to compare the kinetics of the in vivo action of equimolar doses of methyl gallate (MG) and epigallocatechin gallate (EGCG) on their capacity to induce DNA damage and to protect against DNA damage induced by 60 Co gamma rays. DNA-damaged cells were determined by single-cell gel electrophoresis (comets) in murine peripheral blood leukocytes. The maximum radioprotective effects of MG and EGCG (approximately 70%) occurred at 15 min after administration when their effect was determined 2 min following irradiation. MG and EGCG have similar radioprotective indexes, which due to their fast response indicate that they are involved in free radical scavenging. Due to the similar radioprotective activities of MG and EGCG, the in vivo radioprotective effects of these agents do not seem to be dependent on the number of hydroxyl groups present in their structures but instead on the presence of the galloyl radical. EGCG induces an early, significant, and persistent increase in the number of DNA-damaged cells and a later and more important increase in the number of damaged cells, suggesting that it has two mechanisms by which it can induce DNA damage. MG at the same molar dose as EGCG caused a significant and persistent increase in DNA damaged cells but to a much lesser extent to that induce by EGCG, suggesting that the galloyl radical is not involved in the mechanism of DNA breaks induction.

Definitive pelvic radiotherapy for patients with newly diagnosed stage IVB cervical cancer: a systematic review.

OBJECTIVE: The objective of this systematic review was to assess the oncologic outcomes of patients with International Federation of Gynecology and Obstetrics (FIGO) 2018 stage IVB cervical cancer receiving definitive pelvic radiotherapy compared with systemic chemotherapy (with or without palliative pelvic radiotherapy). METHODS: This study was registered in PROSPERO (registration number CRD42022333433). A systematic literature review was conducted following the MOOSE checklist. MEDLINE (through Ovid), Embase, and Cochrane Central Register of Controlled Trials were searched from inception until August 2022. The inclusion criteria were patients with metastatic FIGO 2018 stage IVB cervical cancer, a histologic subtype of squamous cell carcinoma, adenocarcinoma, or adenosquamous carcinoma that received definitive pelvic radiotherapy (≥45 Gy) as part of management compared with systemic chemotherapy with or without palliative (30 Gy) pelvic radiotherapy. Randomized controlled trials and observational studies with two arms of comparison were considered. RESULTS: The search identified 4653 articles; 26 studies were considered potentially eligible after removing duplicates, and 8 met the selection criteria. In total, 2424 patients were included. There were 1357 and 1067 patients in the definitive radiotherapy and chemotherapy groups, respectively. All included studies were retrospective cohort studies, and two were database population studies. The median overall survival reported in seven studies for the definitive radiotherapy arm versus systemic chemotherapy groups were 63.7 months versus 18.4 months (p<0.01), 14 months versus 16 months (p value not reported), 17.6 months versus 10.6 months (p<0.01), 32 months versus 24 months (p<0.01), 17.3 months versus 10 months (p<0.01), and 41.6 months versus 17.6 months (p<0.01), and not reached versus 19 months (p=0.13) respectively, favoring the groups that received definitive pelvic radiotherapy. The high clinical heterogeneity precluded the performance of meta-analysis, and all studies were at serious risk of bias. CONCLUSIONS: Definitive pelvic radiotherapy as part of treatment in patients with stage IVB cervical cancer may improve oncologic outcomes compared with systemic chemotherapy (with or without palliative radiotherapy); however, this is based on low-quality data. Prospective evaluation would be ideal before the adoption of this intervention in standard clinical practice.

Seroprevalence of Trypanosoma cruzi in Eight Blood Banks in Mexico.

BACKGROUND: The true prevalence of Chagas disease in Mexico is unknown. However, it has been estimated that 1.1-4 million people are infected with Trypanosoma cruzi, which represents a potential risk for transmission of the disease via contaminated blood. AIM OF THE STUDY: To determine the Chagas disease seroprevalence in donors from eight blood banks in the north of Mexico City, and the northeast of the State of Mexico. STUDY DESIGN AND METHODS: Serum samples from blood donors (n = 515,038) were tested to detect the presence of anti-Trypanosoma cruzi antibodies in eight blood banks. The serologic screening test was performed in each of the blood banks. To confirm the seropositive blood donors, only two out of the eight blood banks used a test with a different principle with the aim of identifying anti-Trypanosoma cruzi antibodies. All tests were validated by the Mexican Institute for Epidemiological Diagnosis and Reference. RESULTS: One thousand two hundred and ten blood donors were seropositive for Trypanosoma cruzi, which represents a 0.23% seroprevalence (95% CI 0.22-0.25%). Of the seropositive blood donors, 97.03 % resided in the northeast area of the State of Mexico, Mexico City, and southern part of the State of Hidalgo. CONCLUSIONS: Active transmission of Chagas disease may be occurring in non-endemic regions in the northeast of the State of Mexico.

Recent Progress of Nanogenerators for Green Energy Harvesting: Performance, Applications, and Challenges.

Natural sources of green energy include sunshine, water, biomass, geothermal heat, and wind. These energies are alternate forms of electrical energy that do not rely on fossil fuels. Green energy is environmentally benign, as it avoids the generation of greenhouse gases and pollutants. Various systems and equipment have been utilized to gather natural energy. However, most technologies need a huge amount of infrastructure and expensive equipment in order to power electronic gadgets, smart sensors, and wearable devices. Nanogenerators have recently emerged as an alternative technique for collecting energy from both natural and artificial sources, with significant benefits such as light weight, low-cost production, simple operation, easy signal processing, and low-cost materials. These nanogenerators might power electronic components and wearable devices used in a variety of applications such as telecommunications, the medical sector, the military and automotive industries, and internet of things (IoT) devices. We describe new research on the performance of nanogenerators employing several green energy acquisition processes such as piezoelectric, electromagnetic, thermoelectric, and triboelectric. Furthermore, the materials, applications, challenges, and future prospects of several nanogenerators are discussed.

Induction and assessment of persistent radioresistance in murine leukocytes in vivo.

The aim of the present study was to investigate whether weekly exposure to gamma rays causes a persistent increase in the number of radioresistant leukocytes in mice in vivo. Using the comet assay, 1 Gy radiation exposure decreased the percentage of leukocytes with less than 5% DNA in the tail (<5% DNAT), and we propose that radioresistance induction might increase the number of cells with <5% DNAT after radiation exposure. We exposed mice to 1 Gy gamma rays weekly for four weeks or 2 Gy per week for nine weeks. We observed a significant increase in cells with <5% DNAT after the third week and up to nine weeks of exposure. We exposed animals to gradually increasing radiation doses and finally challenged the lymphocytes with 1 Gy radiation both in vivo and in vitro. We observed increased radioresistance in vitro, providing evidence that a cellular process is involved. However, more radioresistance was observed in vivo than in vitro, suggesting a physiological effect. Cells challenged in vitro were maintained on ice during and after exposure, which likely caused a reduction in DNA repair. Radioresistance induction likely arose from mutation selection in stem cells because leukocytes are unable to proliferate in peripheral blood.

Open vs minimally invasive radical trachelectomy in early-stage cervical cancer: International Radical Trachelectomy Assessment Study.

BACKGROUND: Minimally invasive radical trachelectomy has emerged as an alternative to open radical hysterectomy for patients with early-stage cervical cancer desiring future fertility. Recent data suggest worse oncologic outcomes after minimally invasive radical hysterectomy than after open radical hysterectomy in stage I cervical cancer. OBJECTIVE: We aimed to compare 4.5-year disease-free survival after open vs minimally invasive radical trachelectomy. STUDY DESIGN: This was a collaborative, international retrospective study (International Radical Trachelectomy Assessment Study) of patients treated during 2005-2017 at 18 centers in 12 countries. Eligible patients had squamous carcinoma, adenocarcinoma, or adenosquamous carcinoma; had a preoperative tumor size of ≤2 cm; and underwent open or minimally invasive (robotic or laparoscopic) radical trachelectomy with nodal assessment (pelvic lymphadenectomy and/or sentinel lymph node biopsy). The exclusion criteria included neoadjuvant chemotherapy or preoperative pelvic radiotherapy, previous lymphadenectomy or pelvic retroperitoneal surgery, pregnancy, stage IA1 disease with lymphovascular space invasion, aborted trachelectomy (conversion to radical hysterectomy), or vaginal approach. Surgical approach, indication, and adjuvant therapy regimen were at the discretion of the treating institution. A total of 715 patients were entered into the study database. However, 69 patients were excluded, leaving 646 in the analysis. Endpoints were the 4.5-year disease-free survival rate (primary), 4.5-year overall survival rate (secondary), and recurrence rate (secondary). Kaplan-Meier methods were used to estimate disease-free survival and overall survival. A post hoc weighted analysis was performed, comparing the recurrence rates between surgical approaches, with open surgery being considered as standard and minimally invasive surgery as experimental. RESULTS: Of 646 patients, 358 underwent open surgery, and 288 underwent minimally invasive surgery. The median (range) patient age was 32 (20-42) years for open surgery vs 31 (18-45) years for minimally invasive surgery (P=.11). Median (range) pathologic tumor size was 15 (0-31) mm for open surgery and 12 (0.8-40) mm for minimally invasive surgery (P=.33). The rates of pelvic nodal involvement were 5.3% (19 of 358 patients) for open surgery and 4.9% (14 of 288 patients) for minimally invasive surgery (P=.81). Median (range) follow-up time was 5.5 (0.20-16.70) years for open surgery and 3.1 years (0.02-11.10) years for minimally invasive surgery (P<.001). At 4.5 years, 17 of 358 patients (4.7%) with open surgery and 18 of 288 patients (6.2%) with minimally invasive surgery had recurrence (P=.40). The 4.5-year disease-free survival rates were 94.3% (95% confidence interval, 91.6-97.0) for open surgery and 91.5% (95% confidence interval, 87.6-95.6) for minimally invasive surgery (log-rank P=.37). Post hoc propensity score analysis of recurrence risk showed no difference between surgical approaches (P=.42). At 4.5 years, there were 6 disease-related deaths (open surgery, 3; minimally invasive surgery, 3) (log-rank P=.49). The 4.5-year overall survival rates were 99.2% (95% confidence interval, 97.6-99.7) for open surgery and 99.0% (95% confidence interval, 79.0-99.8) for minimally invasive surgery. CONCLUSION: The 4.5-year disease-free survival rates did not differ between open radical trachelectomy and minimally invasive radical trachelectomy. However, recurrence rates in each group were low. Ongoing prospective studies of conservative management of early-stage cervical cancer may help guide future management.

Mesoporous thin films on graphene FETs: nanofiltered, amplified and extended field-effect sensing.

The ionic screening and the response of non-specific molecules are great challenges of biosensors based on field-effect transistors (FETs). In this work, we report the construction of graphene based transistors modified with mesoporous silica thin films (MTF-GFETs) and the unique (bio)sensing properties that arise from their synergy. The developed method allows the preparation of mesoporous thin films free of fissures, with an easily tunable thickness, and prepared on graphene-surfaces, preserving their electronic properties. The MTF-GFETs show good sensing capacity to small probes that diffuse inside the mesopores and reach the graphene semiconductor channel such as H+, OH-, dopamine and H2O2. Interestingly, MTF-GFETs display a greater electrostatic gating response in terms of amplitude and sensing range compared to bare-GFETs for charged macromolecules that infiltrate the pores. For example, for polyelectrolytes and proteins of low MW, the amplitude increases almost 100% and the sensing range extends more than one order of magnitude. Moreover, these devices show a size-excluded electrostatic gating response given by the pore size. These features are even displayed at physiological ionic strength. Finally, a developed thermodynamic model evidences that the amplification and extended field-effect properties arise from the decrease of free ions inside the MTFs due to the entropy loss of confining ions in the mesopores. Our results demonstrate that the synergistic coupling of mesoporous films with FETs leads to nanofiltered, amplified and extended field-effect sensing (NAExFES).

Factores de riesgo de baja masa ósea en mujeres premenopáusicas con lupus eritematoso sistémico / Risk factors for low bone mass in premenopausal women with systemic lupus erythematosus

RESUMEN Introducción: los pacientes con lupus eritematoso sistémico tienen un riesgo elevado de presentar baja masa ósea. La etiología es multifactorial (factores de riesgo tradicionales, propios de la enfermedad, laboratoriales, serológicos, metabólicos y los relacionados al tratamiento). Objetivo: determinar los factores de riesgo de baja masa ósea tradicionales (sedentarismo, tabaquismo, alcohol, baja ingesta láctea, bajo índice de masa corporal), los relacionados con la enfermedad (presentación clínica, laboratoriales), metabólicos y el tratamiento, con la disminución de la densidad mineral ósea en mujeres premenopáusicas con lupus eritematoso sistémico Metodología: estudio observacional de corte transverso prospectivo analítico de mujeres premenopáusicas con lupus eritematoso sistémico, que acudieron al Hospital Nacional en el periodo octubre 2017 - octubre 2019. La densidad mineral ósea se evaluó por densitometría DEXA, y se utilizó el Z score, valores iguales o inferiores a -2,0 DS se consideró como baja masa ósea. Las variables analizadas fueron: factores de riesgo de baja masa ósea tradicionales, relacionados con el lupus, laboratoriales, serológicos, metabólicos y el tratamiento. Análisis estadístico: para la descripción de las variables se utilizaron media y desviación estándar para las variables continuas; y proporciones para las cualitativas. Se establecieron los factores de riesgo para baja masa ósea por la prueba de Chi cuadrado considerándose significativa un valor p ˂0,05, para la comparación de medias se utilizó la prueba t de Student. Resultado: fueron estudiadas 61 mujeres premenopáusicas, con una edad media 25,6 ± 7 años, siendo del interior de país 50,8 % y Central 49,18 %. Tenían estudios secundarios 54,10 %, terciarios 34,43 %, primarios 11,48 %. Eran sedentarias 40,98 %. Presentaron una baja ingesta láctea el 21,31 % y una era fumadora activa 1,64 %. Tenían peso normal 66,2 %, sobrepeso 15,25 %, obesidad 18,33 %, bajo peso 1,64 %. El tiempo de enfermedad, la media fue 50,5 ± 56,4 meses. El índice de actividad de la enfermedad (SLEDAI) fue 6,5 ± 6,5. Presentaron una duración de la enfermedad mayor de 5 años el 31,5 %. Tenían nefritis lúpica 52,54 %, actividad severa 24,5 %, hipocomplementemia 45 %. ANA media 995,5 ± 1164, anti DNA media 274,2 ± 830,8, anti Ro positivo 54,7 %, anti Sm positivo 24,5 %. Vitamina D valor normal 18,5 %, insuficiente 50,9 %, deficiente 32,6 %. Presentaron baja masa ósea 7 pacientes 11,4 %. No se encontró una asociación entre los factores de riesgo tradicionales, los relacionados con la enfermedad (inflamación sistémica, laboratoriales), metabólicos y el tratamiento con una baja masa ósea, (p ≥ 0,05). Conclusión: presentaron una baja masa ósea 11,4 %. Los factores de riesgo tradicionales, los relacionados con la enfermedad, laboratoriales, metabólicos y el tratamiento no presentaron una asociación estadísticamente significativa con la baja masa ósea.

ABSTRACT Introduction: patients with systemic lupus erythematosus have a high risk of presenting low bone mass. The etiology is multifactorial (traditional risk factors, characteristic of the disease, laboratory, serological, metabolic and those related to treatment). Objective: to determine the traditional risk factors for low bone mass (sedentary lifestyle, smoking, alcohol, low milk intake, low body mass index), those related to the disease (clinical presentation, laboratory), metabolic and treatment, with the decrease of bone mineral density in premenopausal women with systemic lupus erythematosus. Methodology: prospective analytical cross-sectional observational study of premenopausal women with systemic lupus erythematosus, who attended the National Hospital in the period October 2017 - October 2019. Bone mineral density was evaluated by DEXA densitometry, and the Z score was used, equal values or lower than -2,0 SD was considered low bone mass. The variables analyzed were: traditional risk factors for low bone mass, related to lupus, laboratory, serological, metabolic and treatment. Statistical analysis: mean and standard deviation for continuous variables were used to describe the variables; and proportions for qualitative ones. The risk factors for low bone mass were established by the Chi square test, considering a p value of ˂0,05 as significant; the Student's t test was used to compare means. Result: 61 premenopausal women were studied, with a mean age 25,6 ± 7 years, being from the interior of the country 50,8 % and Central 49,18 %. They had secondary studies 54,10 %, tertiary 34,43 %, primary 11,48 %. 40,98 % were sedentary. 21,31 % had a low milk intake and 1,64 % was an active smoker. They were 66,2 % normal weight, 15,25 % overweight, 18,33 % obese, 1,64 % underweight. The mean time of illness was 50,5 ± 56,4 months. The disease activity index (SLEDAI) was 6,5 ± 6,5. 31,5 % had a duration of the disease greater than 5 years. They had lupus nephritis 52,54 %, severe activity 24,5 %, hypocomplementemia 45 %. Mean ANA 995,5 ± 1164, mean anti DNA 274,2 ± 830,8, anti Ro positive 54,7 %, anti Sm positive 24,5 %. Vitamin D normal value 18,5 %, insufficient 50,9 %, deficient 32,6 %. 7 patients had low bone mass, 11,4 %. No association was found between traditional risk factors, those related to the disease (systemic inflammation, laboratory), metabolic and treatment with low bone mass, (p ≥ 0,05). Conclusion: they had a low bone mass 11,4 %. The traditional risk factors, those related to the disease, laboratory, metabolic and treatment did not present a statistically significant association with low bone mass.

Thermodynamics of cell penetrating peptides on lipid membranes: sequence and membrane acidity regulate surface binding.

Cell-penetrating peptides (CPPs) are molecules that traverse cell membranes and facilitate the cellular uptake of nano-sized cargoes. In this work we characterize the adsorption of amphipathic and purely cationic CPPs on membranes containing acidic lipids. We describe how the peptide primary sequence, the location of amino-acids within the sequence, the membrane composition, and the pH of the environment, determine both the surface concentration of the peptides and the molecular organization of the interface. Our results are obtained by applying a molecular theory that takes into account the size, shape, protonation state, charge distribution and conformational flexibility of the peptides, as well as the acid-base chemistry of the lipids. We find that peptide adsorption and binding free energy result from a balance between electrostatic and van der Waals interactions, and between chemical and entropic effective forces. We observe that, within a range of physiologically relevant parameters, acidic lipids respond to pH in ways that fully promote or deplete the surface accumulation of CPPs. Membrane acidity emerges thus as a crucial parameter to consider when designing CPP-based cargo-delivery vehicles.

Breaking Simple Scaling Relations through Metal-Oxide Interactions: Understanding Room-Temperature Activation of Methane on M/CeO2 (M = Pt, Ni, or Co) Interfaces.

The clean activation of methane at low temperatures remains an eminent challenge and a field of competitive research. In particular, on late transition metal surfaces such as Pt(111) or Ni(111), higher temperatures are necessary to activate the hydrocarbon molecule, but a massive deposition of carbon makes the metal surface useless for catalytic activity. However, on very low-loaded M/CeO2 (M = Pt, Ni, or Co) surfaces, the dissociation of methane occurs at room temperature, which is unexpected considering simple linear scaling relationships. This intriguing phenomenon has been studied using a combination of experimental techniques (ambient-pressure X-ray photoelectron spectroscopy, time-resolved X-ray diffraction, and X-ray absorption spectroscopy) and density functional theory-based calculations. The experimental and theoretical studies show that the size and morphology of the supported nanoparticles together with strong metal-support interactions are behind the deviations from the scaling relations. These findings point toward a possible strategy for circumventing scaling relations, producing active and stable catalysts that can be employed for methane activation and conversion.

El ultrasonido, de la cabecera del paciente al aula / Ultrasound, from the Patient's Bedside to the Classroom

Resumen: En los últimos años la ecografía a la cabecera del paciente ha crecido exponencialmente. Su aplicación es observada en el quirófano, en las unidades de cuidados intensivos, en urgencias, en la atención de primer nivel e incluso en el trabajo de campo. Es tan versátil que facilita el diagnóstico, mejora la monitorización de los pacientes y apoya en los procedimientos invasivos, todo esto de forma segura y eficaz. En el área de la educación médica ha permeado hasta el pregrado, donde ya se le propone como una herramienta didáctica que permite la vinculación entre el conocimiento de las ciencias básicas y la aplicación clínica. La ecografía corresponde a uno de los instrumentos más versátiles en la medicina contemporánea, por lo que se hace obligada y prioritaria una mayor capacitación e investigación en el tema.

Abstract: In recent years, ultrasound at the patient's bedside has exponentially grown. Its application has been observed in the operating room, intensive care units, emergency rooms, first-level care and even in field work. It is so versatile that it facilitates diagnosis, improves patient monitoring and supports invasive procedures, all in a safe and effective manner. It has been used as a didactic tool in medical education that helps create a link between basic sciences and clinical application. Ultrasound is one of the most versatile instruments in contemporary medicine, hence, more training and research in the subject is a must and a priority.

Tuberculosis abdominal en niños de un hospital público de tercer nivel en México / Abdominal tuberculosis in children of a public tertiary hospital in Mexico

INTRODUCCIÓN. A nivel mundial la tuberculosis es una de las diez causas de muerte, con una incidencia de 7 920 pacientes entre 0 ­ 14 años en la región de América; siendo el abdomen el sitio extrapulmonar más común. OBJETIVOS. Describir las características etarias, clínicas, microbio-lógicas, complicaciones y comorbilidades asociadas en los pacientes pediátricos con tuberculosis abdominal. MATERIALES Y MÉTODOS. Estudio retrospectivo, base de datos de 23 pacientes y edades de 0 meses a 17 años 11 meses y 29 días de edad con evidencia confirmatoria de la presencia del microorganismo; de los servicios de Gastroenterología y Epidemiología en el Nuevo Hospital Civil de Guadalajara "Dr. Juan I. Menchaca ", período 2007 a 2018. RESULTADOS. Se informaron 47,8% (11; 23) de sexo masculino y 52,2% (12; 23) de sexo femenino; 26,1% (6; 23) con antecedente de ingesta de lácteos no pasteurizados. Los tres datos clínicos más frecuentes fueron dolor abdominal, fiebre y pérdida de peso. El 8,7% (2;23) tuvieron convivencia con personas con tuberculosis activa positivo; 30,4% (7; 23) registraron prueba cutánea de derivado proteico pu-rificado positiva; 30,4% (7; 23) identificación de bacterias ácido-alcohol resistentes positivo; 43,5% (10; 23) estudios de imagen compatibles; 8,7% (2; 23) proteína C reactiva de mucosa intestinal po-sitivo; 4,3% (1; 36) cultivo positivo y 8,7% (2; 23) pacientes con inmunodeficiencia. CONCLUSIÓN. La tuberculosis abdominal, se presentó en menores de edad con síntomas inespecíficos de dolor abdominal, fiebre y pérdida de peso, expuestos a ingesta de productos lácteos no pasteurizados, combe positivo e inmunodeficiencia.

INTRODUCTION. Worldwide, tuberculosis is one of the ten causes of death, with an incidence of 7 920 patients between 0 - 14 years in the Americas region; the abdomen being the most common extrapulmonary site. OBJECTIVES. Describe the age, clinical, microbiological, complications and associated comorbidities in pediatric patients with abdominal tuberculosis. MATERIALS AND ME-THODS. Retrospective study, database of 23 patients and ages from 0 months of age to 17 years 11 months and 29 days of age with confirmatory evidence of the presence of the microorganism; of the Gastroenterology and Epidemiology services at the New Civil Hospital of Guadalajara "Dr. Juan I. Menchaca ", period 2 007 to 2 018. RESULTS. 47,8% (11; 23) men and 52,2% (12; 23) women were reported; 26,1% (6; 23) with a history of unpasteurized dairy intake. The three most frequent clinical data were abdominal pain, fever and weight loss. 8,7% (2; 23) lived together with people with positive active tuberculosis; 30,4% (7; 23) recorded a positive purified protein derivative skin test; 30,4% (7; 23) positive acid-alcohol resistant bacteria identification; 43,5% (10; 23) compatible imaging studies; 8,7% (2; 23) positive intestinal mucosal C-reactive protein; 4,3% (1; 36) positive culture and 8,7% (2; 23) patients with immunodeficiency. CONCLUSION. Abdominal tuberculosis occurred in minors with nonspecific symptoms of abdominal pain, fever and weight loss, exposed to intake of unpasteurized dairy products, positive combe and immunodeficiency

Ética y psicología social comunitaria entre los "psicólogos en formación" de una universidad pública del norte de México / Ethics and community social psychology among the "psychologists in training" of a public university in northern Mexico / Ética e psicologia social comunitária entre os "psicólogos em formação" de uma universidade pública do norte do México

El presente estudio trata de responder a la necesidad de reflexionar, desde la ética, sobre el desarrollo de la Psicología y de la formación universitaria con pertinencia social. En este caso, sobre los "psicólogos en formación" de una universidad pública del norte de México, en el trabajo comunitario. A partir de un abordaje cualitativo con herramientas como la entrevista a profundidad y grupos focales, así como la revisión de asignaturas donde se plantea lo comunitario, los significados y reflexiones expresados por alumnos y docentes dejan en claro la apuesta por el trabajo desde la comunidad y el interés porque éste se realice de mejor forma. La necesidad de un trabajo con las comunidades, con un sentido ético, implica no sólo la información sino también su participación y la posibilidad de generar cambios sociales que se traduzcan en el bienestar de las comunidades.

The present paper tries to meet the need to reflect on the development of an ethical Psychology, and university education with social relevance. In this case, on the "psychologists in training" of a public university in northern Mexico, in community work. Using a qualitative approach, with techniques such as in-depth interviews and focus groups, as well as the review of subjects where the community is raised, the meanings and reflections expressed by students and teachers make clear the commitment to work from the community, and the interest to do it in the best possible way. The need to work with an ethical sense, from the communities, implies not only the information, but also their participation and the possibility of generating social changes that translate into the well-being of the communities.

O presente trabalho responde à necessidade de refletir, desde a ética, sobre o desenvolvimento da Psicologia e da formação superior com uma perspectiva comunitária. Para tanto foi realizada uma investigação com "psicólogos em formação" de uma universidade pública localizada na região norte do México enfocando as especificidades do "trabalho comunitário" ofertado na formação profissional. A partir de uma abordagem qualitativa e o uso de ferramentas como a entrevista em profundidade e grupos focais, assim como a revisão das ementas em que se identificou a categoria "comunitário", verificamos que os significados e as reflexões enfocados pelos alunos e docentes expressam uma certa aposta pelo trabalho desde as localidades e o interesse por acompanhar o seu desenvolvimento. A necessidade do trabalho com as comunidades incluindo pautas éticas implica não apenas o processamento da informação, mas também a participação ativa de quem pesquisa e a possibilidade de gerar mudanças sociais que se traduzam em bem-estar para as comunidades.

Adsorption and insertion of polyarginine peptides into membrane pores: The trade-off between electrostatics, acid-base chemistry and pore formation energy.

The mechanism that arginine-rich cell penetrating peptides (ARCPPs) use to translocate lipid membranes is not entirely understood. In the present work, we develop a molecular theory that allows to investigate the adsorption and insertion of ARCPPs on membranes bearing hydrophilic pores. This method accounts for size, shape, conformation, protonation state and charge distribution of the peptides; it also describes the state of protonation of acidic membrane lipids. We present a systematic investigation of the effect of pore size, peptide concentration and sequence length on the extent of peptide adsorption and insertion into the pores. We show that adsorption on the intact (non-porated) lipid membrane plays a key role on peptide translocation. For peptides shorter than nona-arginine, adsorption on the intact membrane increases significantly with chain length, but it saturates for longer peptides. However, this adsorption behavior only occurs at relatively low peptide concentrations; increasing peptide concentration favors adsorption of the shorter molecules. Adsorption of longer peptides increases the intact membrane negative charge as a result of further deprotonation of acidic lipids. Peptide insertion into the pores depends non-monotonically on pore radius, which reflects the short range nature of the effective membrane-peptide interactions. The size of the pore that promotes maximum adsorption depends on the peptide chain length. Peptide translocation is a thermally activated process, so we complement our thermodynamic approach with a simple kinetic model that allows to rationalize the ARCPPs translocation rate in terms of the free energy gain of adsorption, and the energy cost of creating a transmembrane pore with peptides in it. Our results indicate that strategies to improve translocation efficiency should focus on enhancing peptide adsorption.

In vivo Characterization of the Radiosensitizing Effect of a Very Low Dose of BrdU in Murine Cells Exposed to Low-Dose Radiation.

The aim of the present study was to characterize the in vivo radiosensitizing effect of a very low dose of bromodeoxyuridine (BrdU) in mice exposed to low-dose radiation by establishing the following: (1) the radiosensitizing effect during DNA synthesis using single-cell gel electrophoresis (SCGE) in murine bone marrow cells, and (2) the number and timing of the mechanisms of genotoxicity and cytotoxicity, as well as the correlation of both end points, using flow cytometry analysis of the kinetics of micronucleus induction in reticulocytes. Groups of mice received intraperitoneal injections of 0.125 mg/g of BrdU 24 h prior to irradiation with 0.5 Gy of 60 Co gamma rays. DNA breaks measured using SCGE were determined at 30 min after exposure to radiation. The kinetics of micronucleated reticulocyte (MN-RET) induction was determined every 8 h after irradiation up to 72 h. The results from both experimental models indicated that low-level BrdU incorporation into DNA increased the sensitivity to 0.5 Gy of radiation, particularly in the S phase. The formation of micronuclei by gamma rays was produced at three different times using two main mechanisms. In the BrdU-substituted cells, the second mechanism was associated with a high cytotoxic effect that was absent in the irradiated BrdU-unsubstituted cells. The third mechanism, in which micronucleus formation was increased in irradiated substituted cells compared with the irradiated nonsubstituted control cells, was also related to an increase in cytotoxicity. Environ. Mol. Mutagen. 60:534-545, 2019. © 2019 Wiley Periodicals, Inc.

Hallazgos endoscópicos en el tubo digestivo secundarios a la ingesta de cáusticos en niños atendidos en el Departamento de Urgencias / Endoscopic findings of the digestive tract secondary to caustic ingestion in children seen at the Emergency Department

Antecedentes. La ingesta de sustancias cáusticas en pediatría constituye una causa frecuente de atención médica en Urgencias. El uso indiscriminado de limpiadores químicos y la facilidad de adquisición son factores determinantes para estas lesiones. Población y métodos. Estudio descriptivo analítico. Se incluyeron niños < 16 años, entre enero de 1998 y diciembre de 2017. Se identificó el agente químico cáustico ingerido por el niño como ácido o alcalino. Se realizó una endoscopía digestiva para tipificar el grado de quemadura. Se comparó el grado de quemadura con el tipo de cáustico; por medio de la prueba de chi² o exacta de Fisher, se consideró significativo el valor de P < 0,05. Resultados. Ingresaron 133 niños en Urgencias por ingesta de cáusticos. El agente cáustico fue ácido en el 41 % y alcalino en el 59 %. El agente ácido más frecuente fue el ácido muriático (36,8 %), mientras que el alcalino fue la sosa (soda) cáustica (41,4 %). La quemadura del esófago fue más frecuente en la ingesta de sosa en comparación con otros cáusticos (p= 0,001), mientras que la quemadura del estómago (p= 0,001) y del duodeno (p= 0,002) fue estadísticamente significativa en la ingesta de ácido muriático. El grupo de edad que más frecuentemente ingirió algún cáustico (93,2 %) fueron los menores de 5 años. Conclusiones. El cáustico ingerido con mayor frecuencia fue un agente alcalino, que provocó quemadura esofágica, mientras que un agente ácido provocó quemaduras en el estómago y el duodeno evidenciadas por endoscopía.

Background. Caustic ingestion in pediatrics is a common cause of visits to the Emergency Department. An indiscriminate use of cleaning chemicals and an easy access to them are determining factors for these injuries. Population and methods. Descriptive, analytical study. Children aged < 16 years hospitalized between January 1998 and December 2017 were included. The ingested caustic substance was identified as acid or alkaline. A gastrointestinal endoscopy was done to establish the burn grade. The grade of the burn was compared to the type of caustic substance using the χ² test or the Fisher's exact test; a P value < 0.05 was considered significant. Results. A total of 133 children were admitted to the Emergency Department due to caustic ingestion. The caustic agent was acid in 41 % of cases and alkaline, in 59 %. The most common acid caustic substance was muriatic acid (36.8 %) and the most common alkaline caustic agent was caustic soda (41.4 %). An esophageal burn was the most common consequence of caustic soda ingestion compared to other caustic agents (p = 0.001), whereas muriatic acid ingestion was the most statistically significant cause of stomach burn (p = 0.001) and duodenal burn (p = 0.002). The age group that most commonly ingested some caustic agent (93.2 %) corresponded to children younger than 5 years. Conclusions. The most common type of ingested caustic agent was alkaline, which caused esophageal burn; whereas, the ingestion of an acid caustic substance caused stomach and duodenal burns, as evidenced by endoscopy.

Endoscopic findings of the digestive tract secondary to caustic ingestion in children seen at the Emergency Department. / Hallazgos endoscópicos en el tubo digestivo secundarios a la ingesta de cáusticos en niños atendidos en el Departamento de Urgencias.

BACKGROUND: Caustic ingestion in pediatrics is a common cause of visits to the Emergency Department. An indiscriminate use of cleaning chemicals and an easy access to them are determining factors for these injuries. POPULATION AND METHODS: Descriptive, analytical study. Children aged < 16 years hospitalized between January 1998 and December 2017 were included. The ingested caustic substance was identified as acid or alkaline. A gastrointestinal endoscopy was done to establish the burn grade. The grade of the burn was compared to the type of caustic substance using the χ2 test or the Fisher's exact test; a P value < 0.05 was considered significant. RESULTS: A total of 133 children were admitted to the Emergency Department due to caustic ingestion. The caustic agent was acid in 41 % of cases and alkaline, in 59 %. The most common acid caustic substance was muriatic acid (36.8 %) and the most common alkaline caustic agent was caustic soda (41.4 %). An esophageal burn was the most common consequence of caustic soda ingestion compared to other caustic agents (p = 0.001), whereas muriatic acid ingestion was the most statistically significant cause of stomach burn (p = 0.001) and duodenal burn (p = 0.002). The age group that most commonly ingested some caustic agent (93.2 %) corresponded to children younger than 5 years. CONCLUSIONS: The most common type of ingested caustic agent was alkaline, which caused esophageal burn; whereas, the ingestion of an acid caustic substance caused stomach and duodenal burns, as evidenced by endoscopy.

Antecedentes. La ingesta de sustancias cáusticas en pediatría constituye una causa frecuente de atención médica en Urgencias. El uso indiscriminado de limpiadores químicos y la facilidad de adquisición son factores determinantes para estas lesiones. Población y métodos. Estudio descriptivo analítico. Se incluyeron niños < 16 años, entre enero de 1998 y diciembre de 2017. Se identificó el agente químico cáustico ingerido por el niño como ácido o alcalino. Se realizó una endoscopía digestiva para tipificar el grado de quemadura. Se comparó el grado de quemadura con el tipo de cáustico; por medio de la prueba de chi2 o exacta de Fisher, se consideró significativo el valor de P < 0,05. Resultados. Ingresaron 133 niños en Urgencias por ingesta de cáusticos. El agente cáustico fue ácido en el 41 % y alcalino en el 59 %. El agente ácido más frecuente fue el ácido muriático (36,8 %), mientras que el alcalino fue la sosa (soda) cáustica (41,4 %). La quemadura del esófago fue más frecuente en la ingesta de sosa en comparación con otros cáusticos (p= 0,001), mientras que la quemadura del estómago (p= 0,001) y del duodeno (p= 0,002) fue estadísticamente significativa en la ingesta de ácido muriático. El grupo de edad que más frecuentemente ingirió algún cáustico (93,2 %) fueron los menores de 5 años. Conclusiones. El cáustico ingerido con mayor frecuencia fue un agente alcalino, que provocó quemadura esofágica, mientras que un agente ácido provocó quemaduras en el estómago y el duodeno evidenciadas por endoscopía.

Direct Conversion of Methane to Methanol on Ni-Ceria Surfaces: Metal-Support Interactions and Water-Enabled Catalytic Conversion by Site Blocking.

The transformation of methane into methanol or higher alcohols at moderate temperature and pressure conditions is of great environmental interest and remains a challenge despite many efforts. Extended surfaces of metallic nickel are inactive for a direct CH4 → CH3OH conversion. This experimental and computational study provides clear evidence that low Ni loadings on a CeO2(111) support can perform a direct catalytic cycle for the generation of methanol at low temperature using oxygen and water as reactants, with a higher selectivity than ever reported for ceria-based catalysts. On the basis of ambient pressure X-ray photoemission spectroscopy and density functional theory calculations, we demonstrate that water plays a crucial role in blocking catalyst sites where methyl species could fully decompose, an essential factor for diminishing the production of CO and CO2, and in generating sites on which methoxy species and ultimately methanol can form. In addition to water-site blocking, one needs the effects of metal-support interactions to bind and activate methane and water. These findings should be considered when designing metal/oxide catalysts for converting methane to value-added chemicals and fuels.

Radical Hysterectomy and Age: Outcomes Comparison Based on a Minimally Invasive vs an Open Approach.

STUDY OBJECTIVE: To compare outcomes of radical hysterectomy (RH) across age groups based on surgical approach: minimally invasive surgery (MIS) vs laparotomy (LP). DESIGN: Cross-sectional retrospective review (Canadian Task Force classification II-2). SETTING: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas M.D. Anderson Cancer Center. PATIENTS: Patients with early-stage cervical cancer who underwent RH at a tertiary cancer center between 1990 and 2013. INTERVENTIONS: Patients were stratified by age group (<50, 50-59, and ≥60 years) and by surgical approach (minimally invasive surgery [MIS] vs laparotomy [LP]). MEASUREMENTS AND MAIN RESULTS: Patients with early-stage cervical cancer who underwent RH were retrospectively reviewed to obtain demographic data, surgical data, and clinical outcomes. We used the Fisher exact, Wilcoxon rank-sum, and Cochran-Mantel-Haenszel tests to compare categorical and continuous variables stratified by surgical approach and age group. A total of 548 patients were evaluated, including 427 (77.9%) who underwent LP (age <50, 84.3%; 50-59, 11.2%; ≥60, 4.5%) and 121 (22.1%) who underwent MIS (age <50, 71.9%; 50-59, 17.3%; ≥60, 10.8%). In the MIS group, 71 patients (58.7%) underwent laparoscopy and 50 (41.3%) underwent robotic surgery. Patients in the MIS group were significantly older and heavier than those in the LP group. The operative time was significantly longer in the MIS group. There was no between-group difference in intraoperative complications in any of the 3 age groups. LP patients had more infectious complications (respiratory, systemic, and wound) than MIS patients in the <50-year age group (53.3% vs 21.8%). The difference between the LP and MIS groups with respect to the postoperative noninfectious complication rate was greatest in the ≥60-year age group (p = .0324). CONCLUSION: The between-group difference in postoperative noninfectious complication rate in the oldest age group was twice that in either of the other 2 age groups (p = .0324), even though the MIS patients were older, heavier, and had a longer operative time compared with the LP patients.