3D phantom for image quality assessment of mammography systems.

Objective.To present an innovative approach for the design of a 3D mammographic phantom for medical equipment quality assessment, estimation of the glandular tissue percentage in the patient's breast, and emulation of microcalcification (µC) breast lesions.Approach.Contrast-to noise ratio (CNR) measurements, as well as spatial resolution and intensity-to-glandularity calibrations under mammography conditions were performed to assess the effectiveness of the phantom. CNR measurements were applied to different groups of calcium hydroxyapatite (HA) and aluminum oxide (AO)µCs ranging from 200 to 600µm. Spatial resolution was characterized using an aluminum plate contained in the phantom and standard linear figures of merit, such as the line spread function and modulation transfer function (MTF). The intensity-to-glandularity calibration was developed using an x-ray attenuation matrix within the phantom to estimate the glandular tissue percentage in a breast with a compressed thickness of 4 cm.Main results.For the prototype studied, the minimum confidence level for detecting HAµCs is 95.4%, while for AOµCs is above 68.3%. It was also possible to determine that the MTF of the commercial mammography machine used for this study at the Nyquist frequency is 41%. Additionally, a one-to-one intensity-to-glandularity calibration was obtained and verified with Monte-Carlo simulation results.Significance.The phantom provides traditional arrangements presented in accreditation phantoms, which makes it competitive with available devices, but excelling in regarding affordability, modularity, and inlays distribution. Moreover, its design allows to be positioned in close proximity to the patient's breast during a medical screening for a simultaneous x-ray imaging, such that the features of the phantom can be used as reference values to specify characteristics of the real breast tissue, such as proportion of glandular/adipose composition and/orµC type and size lesions.

Evolución y calidad de vida a los tres meses tras hospitalización por neumonía COVID / Evolution and quality of life at three months after hospitalization for COVID pneumonia

Objetivo: Conocer la evolución y calidad de vida relacionada con la salud a los tres meses del alta, en pacientes que fueron hospitalizados en el hospital de Fuenlabrada con diagnóstico de neumonía por COVID-19, valorados por el Servicio de Rehabilitación y que realizaron fisioterapia. Métodos: Se recogen datos de 59 pacientes, diferenciando los que fueron valorados en UCI (41 pacientes), de los valorados en planta de hospitalización (18). Los datos se toman de su historia clínica electrónica, y se realiza una entrevista telefónica tres meses después del alta hospitalaria. Se analizan datos de su evolución durante hospitalización, tras el alta y durante los meses siguientes, y de su situación en el momento de la entrevista. Se pide a los pacientes una valoración de la fisioterapia recibida y que contesten el cuestionario de calidad de vida relacionado con la salud SF-36. Resultados: Estos pacientes han tenido la peor evolución de su neumonía COVID de entre los ingresados en nuestro hospital, pero tuvieron una buena recuperación funcional con la fisioterapia intrahospitalaria recibida, la cual fue valorada muy positivamente por los pacientes. Después de tres meses, el 84% tienen síntomas persistentes, siendo los más frecuentes disnea, cansancio y depresión/ansiedad, y tienen peores puntuaciones en SF-36 que la población de referencia. Conclusiones: La mayoría de los pacientes que requieren rehabilitación durante su hospitalización por neumonía COVID-19, tienen síntomas persistentes y perciben un deterioro de su calidad de vida relacionada con la salud, tras tres meses del alta hospitalaria.(AU)

Objective: Assess clinical evolution and health-related quality of life at three months after discharge in patients who were admitted and diagnosed with COVID-19 pneumonia, evaluated by the Rehabilitation Service and received physiotherapy in Fuenlabrada Hospital. Methods: Data were collected from 59 patients, separating those who were assessed in ICU (41 patients) from those assessed in the hospital ward (18). Data were obtained from their Electronic Medical Record, and a telephone interview was performed three months after their discharge. Data about their clinical progress during their hospitalization, after discharge, over the next months and their condition at the time of the interview is analyzed. Patients were asked to assess the quality of the physiotherapy received and to answer the SF-36 health-related quality of life questionnaire. Results: These patients had the worst progress of the COVID pneumonia among all patients hospitalized in our hospital, but they had a good functional recovery with the inpatient physiotherapy received, which was positively rated. After three months, 84% have persistent symptoms, with the most common being dyspnoea, fatigue and anxiety/depression, and score worse in the SF-36 questionnaire than the reference population. Conclusions: Most patients who require rehabilitation during their COVID pneumonia admission have persistent symptoms and perceive a deterioration in their health-related quality of life after three months of discharge.(AU)

Ácido úrico herramienta de tamización para preeclampsia. Una revisión sistemática de la literatura / Uric acid screening tool for preeclampsia a systematic review

Introducción: El ácido úrico se ha descrito como un posible marcador de riesgo para la aparición de preeclampsia; sin embargo, hasta el momento no hay evidencia sólida que lo soporte. El objetivo de este estudio es sintetizar la literatura disponible que permita conocer la utilidad del ácido úrico como una herramienta de tamización para preeclampsia. Metodología: Revisión sistemática de la literatura de estudios primarios que analicen los niveles séricos de ácido úrico en el primer y segundo trimestre de gestación con el desarrollo de preeclampsia. Búsqueda en Pubmed (n: 639). Resultados: Se incluyeron 2 estudios de cohorte con un total de 9.746 gestantes y 398 casos de preeclampsia. En los estudios se encontraron mayores niveles séricos de ácido úrico en las gestantes que desarrollaron preeclampsia (OR 1,8 a 2,0). Conclusiones: El ácido úrico se relaciona con la aparición de preeclampsia y su fisiopatología. Se invita a la comunidad científica a seguir investigando acerca de la utilidad del ácido úrico para su implementación como herramienta de tamización en el primer y el segundo trimestre de embarazo.(AU)

Introduction: Uric acid has been described as a possible risk marker for the appearance of pre-eclampsia. However, so far there is no solid evidence to support it. The objective of this study is to synthesize the available literature to determine the usefulness of uric acid as a screening tool for pre-eclampsia. Methodology: Systematic review of the literature of primary studies that analyse serum uric acid levels in the first and second trimesters of gestation with the development of pre-eclampsia. Search in PubMed (n: 639). Results: Two studies (2 cohort studies) were included with a total of 9,746 pregnant women and 398 cases of pre-eclampsia. In the studies, higher serum uric acid levels were found in pregnant women who developed preeclampsia (OR 1.8 to 2.0). Conclusions: Uric acid is related to the presence of preeclampsia and its pathophysiology. The scientific community is invited to continue investigating the applicability of uric acid for its implementation as a screening tool in the first and second trimester of pregnancy.(AU)

Verrugas plantares recalcitrantes tratadas exitosamente con sólo una sesión de Láser PDL. A propósito de 3 casos / Recalcitrant plantar warts successfully treated with one PDL session. About 3 cases

Resumen Las verrugas plantares son una patología común en la población. Estas lesiones son a menudo dolorosas y recidivantes. Entre los tratamientos más utilizados están las terapias tópicas destructivas y menos frecuentemente el tratamiento quirúrgico. Sin embargo, con frecuencia recurren, por lo que representan un desafío para el dermatólogo. Presentamos 3 casos de pacientes varones adultos con verrugas plantares recalcitrantes que fueron tratadas exitosamente con una sola sesión de láser PDL, sin recidiva luego de 8 a 12 meses de seguimiento.

Abstract Plantar warts are a common pathology in the population. These lesions are often painful and recurring. Among the most used treatments are topical destructive therapies, and less frequently, surgical treatment. However, they frequently recur, so they represent a challenge for the dermatologist. We present 3 adult males with a recalcitrant plantar wart that were successfully treated with a single PDL laser session, without relapse after 8-12 months of follow-up.

[Evolution and quality of life at three months after hospitalization for COVID pneumonia]. / Evolución y calidad de vida a los tres meses tras hospitalización por neumonía COVID.

OBJECTIVE: Assess clinical evolution and health-related quality of life at three months after discharge in patients who were admitted and diagnosed with COVID-19 pneumonia, evaluated by the Rehabilitation Service and received physiotherapy in Fuenlabrada Hospital. METHODS: Data were collected from 59 patients, separating those who were assessed in ICU (41 patients) from those assessed in the hospital ward (18). Data were obtained from their Electronic Medical Record, and a telephone interview was performed three months after their discharge. Data about their clinical progress during their hospitalization, after discharge, over the next months and their condition at the time of the interview is analyzed. Patients were asked to assess the quality of the physiotherapy received and to answer the SF-36 health-related quality of life questionnaire. RESULTS: These patients had the worst progress of the COVID pneumonia among all patients hospitalized in our hospital, but they had a good functional recovery with the inpatient physiotherapy received, which was positively rated. After three months, 84% have persistent symptoms, with the most common being dyspnoea, fatigue and anxiety/depression, and score worse in the SF-36 questionnaire than the reference population. CONCLUSIONS: Most patients who require rehabilitation during their COVID pneumonia admission have persistent symptoms and perceive a deterioration in their health-related quality of life after three months of discharge.

Degradation of diclofenac in water under LED irradiation using combined g-C3N4/NH2-MIL-125 photocatalysts.

This study reports the photocatalytic degradation of diclofenac by hybrid materials prepared by combination of graphitic carbon nitride (g-C3N4) and titanium-metal organic framework (NH2-MIL-125), in different mass proportions (MOF:C3N4 of 25:75, 50:50 and 75:25). The hybrid materials were fully characterized, and their properties compared to those of the individual components, whose presence was confirmed by XRD. The porous structure was the result of the highly microporous character of the MOF and the non-porous one of g-C3N4. The band gap values were very close to that of MOF component. Photoluminescence measurements suggested an increase on the recombination rate associated to the presence of g-C3N4. Photodegradation tests of diclofenac (10 mg·L-1) were performed under UV LED irradiation at 384 nm. The hybrid materials showed higher photocatalytic activity than the individual components, suggesting the occurrence of some synergistic effect. The photocatalyst with a MOF:g-C3N4 ratio of 50:50 yielded the highest conversion rate, allowing complete disappearance of diclofenac in 2 h. Experiments with scavengers showed that superoxide radicals and holes played a major role in the photocatalytic process photodegradation, being that of hydroxyl radicals less significant. From the identification of by-products species, a degradation pathway was proposed for the degradation of diclofenac under the experimental operating conditions.

Effects of a randomized controlled trial of a brief, student-nurse led, parent-based sexual health intervention on parental protective factors and HPV vaccination uptake.

BACKGROUND: Parents play a pivotal role in adolescent sexual health and Human Papillomavirus (HPV) vaccination. Nurses are on the frontlines of healthcare and play a critical role in promoting HPV vaccination and parent-child sexual health communication. We enhanced the Families Talking Together (FTT) parent-based sexual health curriculum to include adolescent vaccinations herein, FTT + HPV, and trained student nurses to provide a strong HPV vaccination and parent-child sexual health communication endorsement. METHODS: Using a randomized attention-controlled trial design, we examined the efficacy of FTT + HPV among 519 parents and their 11-14 year old youth recruited from medically underserved communities between 2015 and 2018. Participants were recruited from 22 after-school programs (e.g., Boys and Girls Clubs) and 19 charter schools. For parents, we examined protective factors including parent-child sexual health communication and parental involvement. For youth, we examined sexual health knowledge, parent-child sexual health communication, and parent-child connectedness. To assess HPV vaccination initiation and completion, we searched IMMTRAC immunization registry records for 85% of youth and used parental report for youth without registry records. Group differences were calculated using the estimated mean difference at one- and six months post-intervention with significance set at the p < 0.05 level. RESULTS: Baseline rates of HPV vaccination were low at 55.7%. No significant difference between the groups was seen in vaccination initiation or completion rates by one-month post-intervention. However, by six-months post intervention, there was a significant difference between the groups with 70.3% of the intervention group initiating the HPV vaccination series vs. 60.6% for the control group (p = 0.02). No difference between the groups was found for HPV series completion at six-months. There were significant differences in condom knowledge (p = 0.04), parent-child connectedness (p = 0.04), and communication frequency (p = 0.001) with greater improvement in the intervention vs. the control group. Rates of sexual activity remained low in both groups throughout the six-month follow-up period. CONCLUSION: A brief parent-based adolescent sexual health and HPV vaccination intervention delivered by student nurses can improve sexual health outcomes including protective parental factors, adolescent sexual health knowledge, and HPV vaccination initiation rates. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02600884 . Prospectively registered September 1, 2015.

Changes in mitochondrial morphology modulate LPS-induced loss of calcium homeostasis in BV-2 microglial cells.

Microglial activation involves both fragmentation of the mitochondrial network and changes in cellular Ca2+ homeostasis, but possible modifications in mitochondrial calcium uptake have never been described in this context. Here we report that activated microglial BV-2 cells have impaired mitochondrial calcium uptake, including lower calcium retention capacity and calcium uptake rates. These changes were not dependent on altered expression of the mitochondrial calcium uniporter. Respiratory capacity and the inner membrane potential, key determinants of mitochondrial calcium uptake, are both decreased in activated microglial BV-2 cells. Modified mitochondrial calcium uptake correlates with impaired cellular calcium signaling, including reduced ER calcium stores, and decreased replenishment by store operated calcium entry (SOCE). Induction of mitochondrial fragmentation through Mfn2 knockdown in control cells mimicked this effect, while inhibiting LPS-induced mitochondrial fragmentation by a dominant negative form of Drp1 prevented it. Overall, our results show that mitochondrial fragmentation induced by LPS promotes altered Ca2+ homeostasis in microglial cells, a new aspect of microglial activation that could be a key feature in the inflammatory role of these cells.

Propuesta de clasificación tomográfica preoperatoria para el tumor del cuerpo carotideo / Proposal for a preoperative tomographic classification for carotid body tumor

OBJETIVO: proponer una clasificación preoperatoria a los pacientes con tumor de cuerpo Carotídeo y relacionarlos con complicaciones postoperatorias. MATERIAL Y MÉTODOS: todos los pacientes operados con diagnóstico de tumor del cuerpo Carotídeo entre el 2005 al 2014 en el Hospital Obrero N° 1 de la Caja Nacional de Salud en La Paz - Bolivia RESULTADOS: se analizaron y operaron 115 pacientes con un promedio de edad de 52 años (DE±11,725 y una moda de 57 años) de los cuales el 109 (94,80%) correspondieron al género femenino con una razón de 18:1. Todos los pacientes eran originarios y residentes de ciudades ubicadas a más de 2500 m.s.n.m. El promedio de evolución fue de 3 años (DE±2,189), y solo 7 pacientes (6,1%) presentan hábito tabáquico. 83 pacientes (72,2%) de los TCC se localizan en el lado izquierdo En las manifestaciones clínicas, todos los pacientes presentan el tumor localizado en el ángulo mandibular, por delante del musculo esternocleidomastoideo, describiéndose un crecimiento paulatino y permanente en 72 sujetos (62,6%), cefalea en 45 (39,1%), presencia de latido en 30 sujetos (26,1%), disfagia en 9 (7,9%), mareos en 16 (13,9%) y disfonía en 6 (5,2%). Entre los signos más evidentes de TCC, se describe el signo de Fontaine en 114 sujetos (99,2%), adenomegalia en 20 (17,4%) y otros menos frecuentes como soplo, abombamiento parafaringeo y compromiso de pares craneales. Todos los pacientes fueron clasificados en ambos sistemas (Shamblin y la nuestra llamada de los Andes). Se describen 39 pacientes (33,2%) con complicaciones postoperatorias, Grado I: 1 paciente sin complicaciones; Grado II: de 58 sujetos, 4 (3,5%) presentaban parálisis temporal del Hipogloso; en el Grado III: de los 41 sujetos, 24 (20,8%) presentaron ligadura de la arteria carótida externa, parálisis del hipogloso y glosofaringeo, lesión de recurrente y del laríngeo superior. En el grupo IV, de los 15 sujetos operados, 11 presentaron complicaciones (9,6% del total y 73% del grupo) entre las cuales están ligadura de la arteria carótida externa, lesión del hipogloso y un paciente con AVC y hemiparesia. Se describe una reoperación (0,86%) y ninguna mortalidad. CONCLUSIÓN: proponer una clasificación preoperatoria que tenga la posibilidad de asociarse a complicaciones y pronóstico.

OBJECTIVE: to propose a preoperative classification of patients with Carotid Body Tumor and relate them to postoperative complications. MATERIAL AND METHODS: all patients operated with a diagnosis of Carotid Body Tumor between 2005 and 2014 at the Obrero Hospital No. 1 of the National Health Fund in La Paz - Bolivia RESULTS: 115 patients with an average age of 52 years (SD±11.725 and a mode of 57 years) were analyzed and operated on, of which 109 (94.80%) corresponded to the female gender with a ratio of 18: 1. All the patients were from and residents of cities located more than 2,500 meters above sea level. The mean evolution was 3 years (SD±2.189), and only 7 patients (6.1%) had a smoking habit. 83 patients (72.2%) of CBTs are located on the left side In the clinical manifestations, all patients present the tumor located in the mandibular angle, in front of the sternocleidomastoid muscle, describing a gradual and permanent growth in 72 subjects (62.6%), headache in 45 (39.1%), presence of heartbeat in 30 subjects (26.1%), dysphagia in 9 (7.9%), dizziness in 16 (13.9%) and dysphonia in 6 (5.2%). Among the most obvious signs of CBT, the Fontaine sign is described in 114 subjects (99.2%), adenomegaly in 20 (17.4%) and other less frequent signs such as murmur, parapharyngeal bulging and cranial nerve involvement. All patients were classified in both systems (Shamblin and ours called from the Andes). 39 patients (33.2%) with postoperative complications were described, grade I: 1 patient without complications; Grade II: of 58 subjects, 4 (3.5%) had temporary hypoglossal paralysis; in Grade III: of the 41 subjects, 24 (20.8%) presented external carotid artery ligation, hypoglossal and glossopharyngeal paralysis, recurrent lesion and superior larynx. In group IV, of the 15 operated subjects, 11 presented complications (9.6% of the total and 73% of the group), among which are external carotid artery ligation, hypoglossal injury and one patient with stroke and hemiparesis. A reoperation (0.86%) and no mortality are described. CONCLUSION: propose a preoperative classification that has the possibility of being associated with complications and prognosis.

Prevalencia de resistencia transmitida a drogas antirretrovirales en pacientes con infección por VIH en Chile (2014-2018)

Background: Transmitted drug resistance (TDR) occurs in patients with HIV infection who are not exposed to antiretroviral drugs but who are infected with a virus with mutations associated with resistance. Aim: To determine the prevalence of TDR and characterize HIV reverse transcriptase and protease mutation patterns. Material and Methods: HIV infected antiretroviral treatment-naive patients treated in three centers between 2014 and 2018 were studied. A genotyping study was carried out. The HIVdb Program (Stanford University) and the World Health Organization (WHO) TDR surveillance mutation list were used to register resistance-associated mutations. Results: We enrolled 220 patients aged a median of 29 (interquartile range (IQR) 24-34) years, 99% men. Median CD4 count was 365 cells/μL (IQR 250-499 cells/μL) and median viral load was 39.150 copies/mL (IQR 9,270 −120,000). The overall prevalence of RTD was 10.45% (95% CI 6.7-15.2, N = 23/220). The higher frequency of TDR was against non-nucleoside reverse transcriptase inhibitors, reaching 9.0% (95% CI 5.6-13.6), followed by nucleoside reverse transcriptase inhibitors reaching 1.8% (95% CI 0.49-4.5) and protease inhibitors reaching 0.45% (95% CI 0.01-2.5). The mutations in reverse transcriptase were M41L, L210W, D67N, K70E, M184V, K103N (6.36%, 95% CI 3.5-10.4), G190A, E138A, K101E, and I84V in protease. Conclusions: These results should prompt a change in recommendations for starting antiretoviral therapy, especially in first-line regimens that include non-nucleoside reverse transcriptase inhibitors.

Speech-based characterization of dopamine replacement therapy in people with Parkinson's disease.

People with Parkinson's (PWP) disease are under constant tension with respect to their dopamine replacement therapy (DRT) regimen. Waiting too long between doses results in more prominent symptoms, loss of motor function, and greater risk of falling per step. Shortened pill cycles can lead to accelerated habituation and faster development of disabling dyskinesias. The Unified Parkinson's Disease Rating Scale (MDS-UPDRS) is the gold standard for monitoring Parkinson's disease progression but requires a neurologist to administer and therefore is not an ideal instrument to continuously evaluate short-term disease fluctuations. We investigated the feasibility of using speech to detect changes in medication states, based on expectations of subtle changes in voice and content related to dopaminergic levels. We calculated acoustic and prosodic features for three speech tasks (picture description, reverse counting, and diadochokinetic rate) for 25 PWP, each evaluated "ON" and "OFF" DRT. Additionally, we generated semantic features for the picture description task. Classification of ON/OFF medication states using features generated from picture description, reverse counting and diadochokinetic rate tasks resulted in cross-validated accuracy rates of 0.89, 0.84, and 0.60, respectively. The most discriminating task was picture description which provided evidence that participants are more likely to use action words in ON than in OFF state. We also found that speech tempo was modified by DRT. Our results suggest that automatic speech assessment can capture changes associated with the DRT cycle. Given the ease of acquiring speech data, this method shows promise to remotely monitor DRT effects.

Wild carnivores, domestic dogs and ticks: shared parasitism in the Brazilian Cerrado.

The increase of contact between natural and rural areas is prominent in Brazil, due to agricultural activities and concern with the environmental conservation. In this context, domestic animals, wild fauna and humans are exposed to mutual exchange of parasites, microorganisms and diseases. We studied tick parasitism of wild carnivores and domestic dogs, and the environmental of questing ticks, in extensive cattle ranch areas intermingled with natural vegetation, and in a natural reserve, both in a region of Cerrado biome, Midwestern Brazil. From 2008 to 2015, we inspected 119 wild carnivores from nine species, and collected six tick species (Amblyomma sculptum, Amblyomma ovale, Amblyomma dubitatum, Amblyomma tigrinum, Dermacentor nitens and Rhipicephalus microplus). The most numerous and infested hosts were Cerdocyon thous, Lycalopex vetulus, Chrysocyon brachyurus, Puma concolor and Conepatus amazonicus. From 139 domestic dogs, we collected A. sculptum, Rhipicephalus sanguineus and R. microplus. From vegetation, samplings resulted in A. sculptum, A. dubitatum, A. ovale, Amblyomma rotundatum and R. microplus, with dominance of A. sculptum. Domestics and wild animals presented high overlapping of infestations by A. sculptum, a generalist and anthropophilic tick species. This tick is the most important vector of the Brazilian spotted fever, a lethal human disease. This fact elicits attention and requires efforts to monitor the presence of pathogens vectored by ticks circulating in this type of agroecosystem, including in other regions of the Brazil, because the most of the natural vegetation remaining have been increasingly immersed in pastures and agricultural matrix.

[Prevalence of transmitted drug resistance in HIV-infected treatment-naive patients in Chile]. / Prevalencia de resistencia transmitida a drogas antirretrovirales en pacientes con infección por VIH en Chile (2014-2018).

BACKGROUND: Transmitted drug resistance (TDR) occurs in patients with HIV infection who are not exposed to antiretroviral drugs but who are infected with a virus with mutations associated with resistance. AIM: To determine the prevalence of TDR and characterize HIV reverse transcriptase and protease mutation patterns. MATERIAL AND METHODS: HIV infected antiretroviral treatment-naive patients treated in three centers between 2014 and 2018 were studied. A genotyping study was carried out. The HIVdb Program (Stanford University) and the World Health Organization (WHO) TDR surveillance mutation list were used to register resistance-associated mutations. RESULTS: We enrolled 220 patients aged a median of 29 (interquartile range (IQR) 24-34) years, 99% men. Median CD4 count was 365 cells/µL (IQR 250-499 cells/µL) and median viral load was 39.150 copies/mL (IQR 9,270 -120,000). The overall prevalence of RTD was 10.45% (95% CI 6.7-15.2, N = 23/220). The higher frequency of TDR was against non-nucleoside reverse transcriptase inhibitors, reaching 9.0% (95% CI 5.6-13.6), followed by nucleoside reverse transcriptase inhibitors reaching 1.8% (95% CI 0.49-4.5) and protease inhibitors reaching 0.45% (95% CI 0.01-2.5). The mutations in reverse transcriptase were M41L, L210W, D67N, K70E, M184V, K103N (6.36%, 95% CI 3.5-10.4), G190A, E138A, K101E, and I84V in protease. CONCLUSIONS: These results should prompt a change in recommendations for starting antiretoviral therapy, especially in first-line regimens that include non-nucleoside reverse transcriptase inhibitors.

Do Workers from Subspecies Acromyrmex subterraneus Prepare Leaves and Toxic Baits in Similar Ways for Their Fungus Garden?

Toxic baits are the most efficient method to control leaf-cutter ants in eucalyptus forests for paper and cellulose production. For the proper use of these baits, insecticide compounds must reach workers and contaminate them. Thus, understanding how these baits are processed inside the nests is vital for a successful control, especially when it comes to genus Acromyrmex. Lack of information on toxic baits and on contamination of Acromyrmex workers raises the question: do workers from subspecies Acromyrmex subterraneus (Forel) prepare leaves and toxic baits in similar ways for their fungus garden? To answer it, this study described and analyzed the behavioral repertoire executed by A. subterraneus workers during the preparation of leaf disks and baits and their incorporation into the fungus garden. Results show that the act of licking the substrate was the most frequently executed behavior, regardless of subspecies or size categories. Moreover, additional behaviors have been observed when workers processed the baits, such as licking and scraping their jaws on the surface of the bait pellet, as well as licking and biting fragments of bait pellets, moistening them. Thus, it is concluded that the preparation of baits is different from that of leaves; baits are more processed and can therefore contribute to contaminating workers via insecticides.

Correction to: Occurrence of anti-Leptospira spp. antibodies in Rhipidomys spp. from a forest fragment of the Brazilian Cerrado.

The original version of this article unfortunately contains an error. Vanessa do Nascimento Ramos was not included in the original article as one of the contributors. The name is now included in the authorgroup.

Contamination Route of Leaf-Cutting Worker Ants Analyzed Through a Fat-Soluble Tracer Dye in Toxic Bait.

Our study seeks to discover contamination routes of leaf-cutting worker ants during chemical control by formicide baits. To do so, toxic baits containing fat-soluble tracer dye were provided to colonies of three subspecies of Acromyrmex under laboratory conditions, in order to assess the proportion of dyed workers by size category, as well as dyed internal morphological structures. Results showed that nearly 50% of the workers come into contact with the active ingredient, since the internal structures of their bodies are dyed by the fat-soluble tracer dye within the first 24 h from contact with the toxic bait. In addition, the three subspecies of leaf-cutting ants present a similarity as to the contamination of their workers, probably due to their specialized behavior performed during the growth of the fungus garden with the baits. We conclude that the workers' pattern of behavior during fungus garden growth was the main means for dispersion of a fat-soluble substance among approximately half of the nest mates in our experiments, serving as a model for further studies on contamination of worker ants with insecticides.

Early referral and control of disease's flares prevent Orthopedic and Hand Surgery Indication (OHSI) in a dynamic cohort of Hispanic early rheumatoid arthritis patients.

BACKGROUND: Reconstructive joint surgery is an indicator of poor prognosis in rheumatoid arthritis (RA). Objectives of this study were to describe the incidence rate of orthopedic and hand surgery indication (OHSI) in an ongoing cohort of Hispanic early RA patients treated according to a T2T strategy and to investigate predictors. METHODS: Through February 2018, the cohort comprised 185 patients recruited from 2004 onwards, with variable follow-up, and rheumatic assessments at fixed intervals that included prospective determination of OHSI. Charts were reviewed by a single data abstractor. OHSI incidence rate was calculated. A case-control study nested within a cohort investigated the predictors; cases (OHSI patients) were paired with controls (1:4) according to age, sex and autoantibodies. A logistic regression model included baseline and cumulative (up to OHSI or equivalent) variables related to disease activity, treatment and to persistence with therapy. The IRB approved the study. RESULTS: Patients from the cohort were predominantly middle-aged (mean ± SD age: 38.5 ± 12.9 years) females (87.6%) with 5.4 ± 2.6 months of disease duration. The cohort contributed to 1538 patient-years of follow-up. Twelve patients received incidental OHSI at a follow-up of 85 ± 44.5 months. The OHSI incident global rate was 8/1000 patient-years. Longer symptom duration at cohort referral (OR: 1.313, 95%CI: 1.02-1.68, p = 0.032) and a higher number of flares/patient (OR: 1.608, 95%CI: 1.05-1.61, p = 0.015) predicted OHSI. OHSI patients had more severe flares than their counterparts, and the opposite figure was true for mild flares. CONCLUSION: Early referral for appropriate management and flare control may prevent OHSI in Hispanic recent-onset RA patients.

Morphological and morphometric characterization of the "sphenoidal tubercle" / Caracterización morfológica y morfométrica del tubérculo esfenoidal

The sphenoidal tubercle is a bone elevation located in the anterior edge of the infratemporal crest of the sphenoid greater wing, where the temporal and lateral pterygoid muscles have their origin. This bone accident presents varied morphology so its description and denomination are a topic of discussion. 60 dry skulls obtained from the morphology laboratory of the Biomedical Basic Sciences Department of the University of Talca were used for a morphological and morphometric analysis of the sphenoidal tubercle including its morphology, diameters (anteroposterior, transverse and vertical) and the distance to the grooves for the maxillary artery and maxillary nerve. Sphenoidal tubercle had a prevalence of 98.4 % of all dry skulls analyzed with a bilateral presentation in the 76.6 % of the cases. According to its different forms of presentation established by Cáceres et al., (2016) the pyramidal form was the most frequent with a 25.7 %. The average diameters were of 4.12 mm anteroposterior, 5.50 mm transverse and 3.89 mm vertical. The average distance to the grooves of the maxillary artery and maxillary nerve were 9.04 mm and 7.6 mm, respectively. Sphenoidal tubercle is a constant bone accident with a variated morphology and measures. Due to its anatomical relations with important neurovascular elements such as the maxillary artery and the maxillary nerve, it may be used as a reference point for surgical access to the infratemporal fossa. From this analysis we establish that the denomination of "infratemporal process" is more accurate, because the development of this bone accident is from muscular traction performed by the lateral pterygoid muscle and the deep portion of the temporal muscle causing great variations in its morphology, probably due to external and functional parameters or even influenced by the biotype.

El tubérculo esfenoidal es una elevación ósea ubicada en el extremo anterior de la cresta infratemporal del ala mayor del hueso esfenoides, donde presta inserción al músculo temporal y pterigoideo lateral. Presenta morfología variada, por lo que su descripción y denominación resultan motivo de discusión. 60 cráneos secos obtenidos del Laboratorio de Morfología del Departamento de Ciencias Básicas Biomédicas de la Universidad de Talca, fueron utilizados para realizar un análisis morfológico y morfométrico del tubérculo esfenoidal evaluando forma, diámetros (anteroposterior, laterolateral y vertical) y distancia con el surco de la arteria y nervio maxilar. El tubérculo esfenoidal tuvo una prevalencia del 98,4 % del total de cráneos analizados, presentándose bilateralmente en el 76,6 % de los casos. De acuerdo a las diferentes formas de presentación establecidas por Cáceres et al (2016) la forma piramidal fue la más frecuente con un 25,7 %. Los diámetros promedio fueron de 4,12 mm anteroposterior, 5,50 mm laterolateral y 3,89 mm vertical. Las distancias promedio con el surco de la arteria y nervio maxilar fueron de 9,04 mm y 7,6mm, respectivamente. El tubérculo esfenoidal es un accidente óseo constante de morfología y dimensiones variadas. Debido a sus relaciones con elementos vasculares de importancia, tales como la arteria y nervio maxilar, podría ser utilizado como elemento de referencia para el acceso quirúrgico a la fosa infratemporal. A partir de su análisis planteamos que su denominación como "proceso infratemporal" sería más apropiado, debido a que se desarrollaría a partir de la tracción muscular ejercida por el musculo pterigoideo lateral y la porción profunda del músculo temporal, ocasionando variaciones notables en su morfología, probablemente debido a factores externos y funcionales o incluso influenciada por el biotipo.

Predictive factors of flares in systemic lupus erythematosus patients: data from a multiethnic Latin American cohort.

Purpose The purpose of this paper is to determine the factors predictive of flares in systemic lupus erythematosus (SLE) patients. Methods A case-control study nested within the Grupo Latino Americano De Estudio de Lupus (GLADEL) cohort was conducted. Flare was defined as an increase ≥4 points in the SLEDAI. Cases were defined as patients with at least one flare. Controls were selected by matching cases by length of follow-up. Demographic and clinical manifestations were systematically recorded by a common protocol. Glucocorticoid use was recorded as average daily dose of prednisone and antimalarial use as percentage of time on antimalarial and categorized as never (0%), rarely (>0-25%), occasionally (>25%-50%), commonly (˃50%-75%) and frequently (˃75%). Immunosuppressive drugs were recorded as used or not used. The association between demographic, clinical manifestations, therapy and flares was examined using univariable and multivariable conditional logistic regression models. Results A total of 465 cases and controls were included. Mean age at diagnosis among cases and controls was 27.5 vs 29.9 years, p = 0.003; gender and ethnic distributions were comparable among both groups and so was the baseline SLEDAI. Independent factors protective of flares identified by multivariable analysis were older age at diagnosis (OR = 0.929 per every five years, 95% CI 0.869-0.975; p = 0.004) and antimalarial use (frequently vs never, OR = 0.722, 95% CI 0.522-0.998; p = 0.049) whereas azathioprine use (OR = 1.820, 95% CI 1.309-2.531; p < 0.001) and SLEDAI post-baseline were predictive of them (OR = 1.034, 95% CI 1.005-1.064; p = 0.022). Conclusions In this large, longitudinal Latin American cohort, older age at diagnosis and more frequent antimalarial use were protective whereas azathioprine use and higher disease activity were predictive of flares.