Plant hydraulics at the heart of plant, crops and ecosystem functions in the face of climate change.

Plant hydraulics is crucial for assessing the plants' capacity to extract and transport water from the soil up to their aerial organs. Along with their capacity to exchange water between plant compartments and regulate evaporation, hydraulic properties determine plant water relations, water status and susceptibility to pathogen attacks. Consequently, any variation in the hydraulic characteristics of plants is likely to significantly impact various mechanisms and processes related to plant growth, survival and production, as well as the risk of biotic attacks and forest fire behaviour. However, the integration of hydraulic traits into disciplines such as plant pathology, entomology, fire ecology or agriculture can be significantly improved. This review examines how plant hydraulics can provide new insights into our understanding of these processes, including modelling processes of vegetation dynamics, illuminating numerous perspectives for assessing the consequences of climate change on forest and agronomic systems, and addressing unanswered questions across multiple areas of knowledge.

Análisis comparativo de la Iniciativa Global para el Asma y las guías sudamericanas para el diagnóstico, manejo y prevención del asma en pacientes pediátricos

Fundamento: el asma es una enfermedad inflamatoria crónica con una alta prevalencia en Sudamérica, por lo que requiere un diagnóstico adecuado, manejo óptimo y medidas de prevención respaldados por evidencia científica constantemente actualizada. Objetivo: realizar un análisis comparativo entre la Iniciativa Global para el Asma y las guías sudamericanas para el diagnóstico, manejo y prevención del asma en pacientes pediátricos. Métodos: estudio de tipo observacional descriptivo que compara la guía Iniciativa Global para el Asma del año 2023 con guías nacionales de los países sudamericanos Colombia, Argentina, Chile, Uruguay, Venezuela y Perú, en los siguientes parámetros: recomendaciones diagnósticas, recomendaciones en el manejo y estrategias de prevención. Resultados: se encontraron diferencias en las recomendaciones de prevención y educación en las guías analizadas, mientras que la Iniciativa Global para el Asma y algunas guías sudamericanas mencionan medidas de prevención, otras guías no las mencionan o tienen información limitada al respecto. En los exámenes auxiliares, todas las guías mencionan la realización de espirometría para evaluar la función pulmonar, pero existen diferencias con la inclusión de otros exámenes, como el test de alergia o la medición de óxido nítrico exhalado. Conclusiones: se requiere una mayor estandarización y actualización de las guías sudamericanas para garantizar un manejo adecuado y consistente del asma en la región.

Foundation: Asthma is a chronic inflammatory disease with a high prevalence in South America, which requires proper diagnosis, optimal management and prevention measures supported by constantly updated scientific evidence. Objective: to carry out a comparative analysis between the Global Initiative for Asthma and the South American guidelines for the diagnosis, management and prevention of asthma in pediatric patients. Methods: descriptive observational study that compares the 2023 Global Initiative for Asthma guideline with national guidelines from the South American countries Colombia, Argentina, Chile, Uruguay, Venezuela and Peru, in the following parameters: diagnostic recommendations, management recommendations and prevention strategies. Results: differences were found in prevention and education recommendations in the guides analyzed, while the Global Initiative for Asthma and some South American guides mention prevention measures, other guides do not mention them or have limited information in this regard. In auxiliary tests, all guidelines mention performing spirometry to evaluate lung function, but there are differences with the inclusion of other tests, such as the allergy test or the measurement of exhaled nitric oxide. Conclusions: Greater standardization and updating of South American guidelines is required to guarantee adequate and consistent management of asthma in the region.

Application of colon leakage score in the left-sided colorectal surgery.

Background: Colon leakage score (CLS) was developed for risk prediction of anastomotic leak (AL) in the left-sided colorectal surgery. Although the risk factors for leakage are well known and accepted by the surgical community, an accurate forecast of AL is still a difficult task. Objective: The study aims to apply the CLS in patients undergoing left-sided colorectal surgery. Methods: Retrospective study in patients with the left-sided colorectal surgery and primary anastomosis without diverting stoma. CLS was calculated in patients, who were classified in AL and NO-AL groups. Predictive value of CLS was evaluated by receiver operator characteristic. Correlation between CLS and AL was determined. 208 patients (55% male, mean age 59 years) were included in the study. Results: Overall, AL was 7.2%. Mean CLS of all patients was 7.2 ± 3.2 (0-17). Patients with AL had a higher CLS (11.8 ± 2.3) than NO-AL patients (6.8 ± 3) (p = 0.0001). The area under the curve for the prediction of AL by CLS was 0.898 ([CI] 0.829-0.968, p = 0.0001). A CLS of 8.5 had 93% sensitivity and 72% specificity. There was a statistically significant odds ratio for CLS and AL (0.58: [CI] 0.46-0.73, p = 0.0001). Conclusion: CLS is a useful tool to predict AL in the left-sided colorectal surgery.

Antecedentes: La puntuación de fugas de colon (CLS) se desarrolló para la predicción del riesgo de fuga anastomótica (AL) en la cirugía colorrectal del lado izquierdo, con la finalidad de obtener un pronóstico preciso. Objetivo: Este estudio tiene el objetivo de aplicar el CLS en pacientes con cirugía colorrectal de lado izquierdo. Método: Estudio retrospectivo en pacientes con cirugía colorrectal izquierda y anastomosis primaria sin estoma de derivación. Se calculó el CLS en los pacientes, los cuales fueron clasificados en los grupos con AL y sin AL. Resultados: La media del CLS de todos los pacientes fue de 7.2 ± 3.2 (0-17). Los pacientes con AL tenían un CLS más alto (11.8 ± 2.3) que los pacientes sin AL (6.8 ± 3) (p = 0.0001). El área bajo la curva para la predicción de la AL mediante el CLS fue de 0.898 (intervalo de confianza (CI) 0.829-0.968; p = 0.0001). Un CLS de 8.5 tuvo una sensibilidad del 93% y una especificidad del 72%. Además, se obtuvo un Odds Ratio con una diferencia estadísticamente significativa para el CLS y AL (0.58; CI 0.46-0.73; p = 0.0001). Conclusión: La CLS es una herramienta útil para predecir la AL en la cirugía colorrectal del lado izquierdo.

Photosynthesis, leaf hydraulic conductance and embolism dynamics in the resurrection plant Barbacenia purpurea.

The main parameters determining photosynthesis are stomatal and mesophyll conductance and electron transport rate, and for hydraulic dynamics they are leaf hydraulic conductance and the spread of embolism. These parameters have scarcely been studied in desiccation-tolerant (resurrection) plants exposed to drought. Here, we characterized photosynthesis and hydraulics during desiccation and rehydration in a poikilochlorophyllous resurrection plant, Barbacenia purpurea (Velloziaceae). Gas exchange, chlorophyll fluorescence, and leaf water status were monitored along the whole dehydration-rehydration cycle. Simultaneously, embolism formation and hydraulic functioning recovery were measured at leaf level using micro-computed tomography imaging. Photosynthesis and leaf hydraulic conductance ceased at relatively high water potential (-1.28 and -1.54 MPa, respectively), whereas the onset of leaf embolism occurred after stomatal closure and photosynthesis cessation (<-1.61 MPa). This sequence of physiological processes during water stress may be associated with the need to delay dehydration, to prepare the molecular changes required in the desiccated state. Complete rehydration occurred rapidly in the mesophyll, whereas partial xylem refilling, and subsequent recovery of photosynthesis, occurred at later stages after rewatering. These results highlight the importance of stomata as safety valves to protect the vascular system from embolism, even in a plant able to fully recover after complete embolism.

The Relationship Between Metabolic Syndrome and Benign Prostate Enlargement: A Case-Control Study in a Peruvian Military Hospital.

OBJECTIVE: This study aimed to determine how metabolic syndrome is related to benign prostatic enlargement in males under 60 years old in a national military hospital in Peru. MATERIALS AND METHODS: We conducted a retrospective, quantitative, case-control study. By simple random sampling, 87 cases with benign prostatic enlargement and 174 controls were included, with a statistical power of 80%. The benign prostatic enlargement was evaluated by clinical picture and ultrasound and the metabolic syndrome was evaluated according to the Adult Treatment Panel III criteria. The statistical analysis was performed using the STATAv14 program, the chi-square statistical test was used and odds ratio was obtained, at a significance level of 5%. RESULTS: The mean age of the cases and controls was 55 (51-58) and 52 (46-57), respectively. By multivariate analysis, the factors related to benign prostatic enlargement were the presence of benign prostatic enlargement (adjusted odds ratio: 2.71, 95% CI: 1.27-5.80; P=.010), waist circumference ≥102 cm (adjusted odds ratio: 6.51, 95% CI: 3.09-13.71; P < .001), elevated fasting glucose (adjusted odds ratio: 1.38, 95% CI: 0.65-2.91; P=.399), high triglycerides (adjusted odds ratio: 5.29, 95%: CI 2.40-11.64; P < .001), and arterial hypertension (adjusted odds ratio: 4.67, 95% CI 2.19-9.95; P < .001). Elevated high-density lipoprotein cholesterol was a protective factor (adjusted odds ratio: 0.09, 95% CI: 0.04-0.20; P < .001). CONCLUSION: The present study showed that metabolic syndrome and its components (waist circumference, hypertension, triglycerides, and high-density lipoprotein cholesterol) are factors related to benign prostatic enlargement in patients under 60 years old in a military hospital in Peruvian population. Waist circumference as an indicator of overweight/obesity is a practical anthropometric marker of interest in public health.

Catalytic generation of ortho-quinone dimethides via donor/donor rhodium carbenes.

Substrates engineered to undergo a 1,4-C-H insertion to yield benzocyclobutenes resulted in a novel elimination reaction to yield ortho-quinone dimethide (o-QDM) intermediates that undergo Diels-Alder or hetero-Diels-Alder cycloadditions. The analogous benzylic acetals or ethers avoid the C-H insertion pathway completely and, after hydride transfer, undergo a de-aromatizing elimination reaction to o-QDM at ambient temperature. The resulting dienes undergo a variety of cycloaddition reactions with high diastereo- and regio-selectivity. This is one of the few examples of catalytic generation of o-QDM without the intermediacy of a benzocyclobutene and represents one of the mildest, ambient temperature processes to access these useful intermediates. This proposed mechanism is supported by DFT calculations. Moreover, the methodology was applied to the synthesis of (±)-isolariciresinol in 41% overall yield.

Key hydraulic traits control the dynamics of plant dehydration in four contrasting tree species during drought.

Trees are at risk of mortality during extreme drought, yet our understanding of the traits that govern the timing of drought-induced hydraulic failure remains limited. To address this, we tested SurEau, a trait-based soil-plant-atmosphere model designed to predict the dynamics of plant dehydration as represented by the changes in water potential against those observed in potted trees of four contrasting species (Pinus halepensis Mill., Populus nigra L., Quercus ilex L. and Cedrus atlantica (Endl.) Manetti ex Carriére) exposed to drought. SurEau was parameterized with a range of plant hydraulic and allometric traits, soil and climatic variables. We found a close correspondence between the predicted and observed plant water potential (in MPa) dynamics during the early phase drought, leading to stomatal closure, as well as during the latter phase of drought, leading to hydraulic failure in all four species. A global model's sensitivity analysis revealed that, for a common plant size (leaf area) and soil volume, dehydration time from full hydration to stomatal closure (Tclose) was most strongly controlled by the leaf osmotic potential (Pi0) and its influence on stomatal closure, in all four species, while the maximum stomatal conductance (gsmax) also contributed to Tclose in Q. ilex and C. atlantica. Dehydration times from stomatal closure to hydraulic failure (Tcav) was most strongly controlled by Pi0, the branch residual conductance (gres) and Q10a sensitivity of gres in the three evergreen species, while xylem embolism resistance (P50) was most influential in the deciduous species P. nigra. Our findings point to SurEau as a highly useful model for predicting changes in plant water status during drought and suggest that adjustments made in key hydraulic traits are potentially beneficial to delaying the onset of drought-induced hydraulic failure in trees.

Protection of Catalytic Cofactors by Polypeptides as a Driver for the Emergence of Primordial Enzymes.

Enzymes catalyze the chemical reactions of life. For nearly half of known enzymes, catalysis requires the binding of small molecules known as cofactors. Polypeptide-cofactor complexes likely formed at a primordial stage and became starting points for the evolution of many efficient enzymes. Yet, evolution has no foresight so the driver for the primordial complex formation is unknown. Here, we use a resurrected ancestral TIM-barrel protein to identify one potential driver. Heme binding at a flexible region of the ancestral structure yields a peroxidation catalyst with enhanced efficiency when compared to free heme. This enhancement, however, does not arise from protein-mediated promotion of catalysis. Rather, it reflects the protection of bound heme from common degradation processes and a resulting longer lifetime and higher effective concentration for the catalyst. Protection of catalytic cofactors by polypeptides emerges as a general mechanism to enhance catalysis and may have plausibly benefited primordial polypeptide-cofactor associations.

Protection of catalytic cofactors by polypeptides as a driver for the emergence of primordial enzymes.

Enzymes catalyze the chemical reactions of life. For nearly half of known enzymes, catalysis requires the binding of small molecules known as cofactors. Polypeptide-cofactor complexes likely formed at a primordial stage and became starting points for the evolution of many efficient enzymes. Yet, evolution has no foresight so the driver for the primordial complex formation is unknown. Here, we use a resurrected ancestral TIM-barrel protein to identify one potential driver. Heme binding at a flexible region of the ancestral structure yields a peroxidation catalyst with enhanced efficiency when compared to free heme. This enhancement, however, does not arise from protein-mediated promotion of catalysis. Rather, it reflects protection of bound heme from common degradation processes and a resulting longer life time and higher effective concentration for the catalyst. Protection of catalytic cofactors by polypeptides emerges as a general mechanism to enhance catalysis and may have plausibly benefited primordial polypeptide-cofactor associations.

Immunoanalytical Approach for Detecting and Identifying Ancestral Peptide Biomarkers in Early Earth Analogue Environments.

Several mass spectrometry and spectroscopic techniques have been used in the search for molecular biomarkers on Mars. A major constraint is their capability to detect and identify large and complex compounds such as peptides or other biopolymers. Multiplex immunoassays can detect these compounds, but antibodies must be produced for a large number of sequence-dependent molecular targets. Ancestral Sequence Reconstruction (ASR) followed by protein "resurrection" in the lab can help to narrow the selection of targets. Herein, we propose an immunoanalytical method to identify ancient and universally conserved protein/peptide sequences as targets for identifying ancestral biomarkers in nature. We have developed, tested, and validated this approach by producing antibodies to eight previously described ancestral resurrected proteins (three ß-lactamases, three thioredoxins, one Elongation Factor Tu, and one RuBisCO, all of them theoretically dated as Precambrian), and used them as a proxy to search for any potential feature of them that could be present in current natural environments. By fluorescent sandwich microarray immunoassays (FSMI), we have detected positive immunoreactions with antibodies to the oldest ß-lactamase and thioredoxin proteins (ca. 4 Ga) in samples from a hydrothermal environment. Fine epitope mapping and inhibitory immunoassays allowed the identification of well-conserved epitope peptide sequences that resulted from ASR and were present in the sample. We corroborated these results by metagenomic sequencing and found several genes encoding analogue proteins with significant matches to the peptide epitopes identified with the antibodies. The results demonstrated that peptides inferred from ASR studies have true counterpart analogues in Nature, which validates and strengthens the well-known ASR/protein resurrection technique and our immunoanalytical approach for investigating ancient environments and metabolisms on Earth and elsewhere.

Cell Survival Enabled by Leakage of a Labile Metabolic Intermediate.

Many metabolites are generated in one step of a biochemical pathway and consumed in a subsequent step. Such metabolic intermediates are often reactive molecules which, if allowed to freely diffuse in the intracellular milieu, could lead to undesirable side reactions and even become toxic to the cell. Therefore, metabolic intermediates are often protected as protein-bound species and directly transferred between enzyme active sites in multi-functional enzymes, multi-enzyme complexes, and metabolons. Sequestration of reactive metabolic intermediates thus contributes to metabolic efficiency. It is not known, however, whether this evolutionary adaptation can be relaxed in response to challenges to organismal survival. Here, we report evolutionary repair experiments on Escherichia coli cells in which an enzyme crucial for the biosynthesis of proline has been deleted. The deletion makes cells unable to grow in a culture medium lacking proline. Remarkably, however, cell growth is efficiently restored by many single mutations (12 at least) in the gene of glutamine synthetase. The mutations cause the leakage to the intracellular milieu of a highly reactive phosphorylated intermediate common to the biosynthetic pathways of glutamine and proline. This intermediate is generally assumed to exist only as a protein-bound species. Nevertheless, its diffusion upon mutation-induced leakage enables a new route to proline biosynthesis. Our results support that leakage of sequestered metabolic intermediates can readily occur and contribute to organismal adaptation in some scenarios. Enhanced availability of reactive molecules may enable the generation of new biochemical pathways and the potential of mutation-induced leakage in metabolic engineering is noted.

A bitter future for coffee production? Physiological traits associated with yield reveal high vulnerability to hydraulic failure in Coffea canephora.

The increase in frequency and intensity of drought events have hampered coffee production in the already threatened Amazon region, yet little is known about key aspects underlying the variability in yield potential across genotypes, nor to what extent higher productivity is linked to reduced drought tolerance. Here we explored how variations in morphoanatomical and physiological leaf traits can explain differences in yield and vulnerability to embolism in 11 Coffea canephora genotypes cultivated in the Western Amazon. The remarkable variation in coffee yield across genotypes was tightly related to differences in their carbon assimilation and water transport capacities, revealing a diffusive limitation to photosynthesis linked by hydraulic constraints. Although a clear trade-off between water transport efficiency and safety was not detected, all the studied genotypes operated in a narrow and/or negative hydraulic safety margin, suggesting a high vulnerability to leaf hydraulic failure (HF), especially on the most productive genotypes. Modelling exercises revealed that variations in HF across genotypes were mainly associated with differences in leaf water vapour leakage when stomata are closed, reflecting contrasting growth strategies. Overall, our results provide a new perspective on the challenges of sustaining coffee production in the Amazon region under a drier and warmer climate.

On the path from xylem hydraulic failure to downstream cell death.

Xylem hydraulic failure (HF) has been identified as a ubiquitous factor in triggering drought-induced tree mortality through the damage induced by the progressive dehydration of plant living cells. However, fundamental evidence of the mechanistic link connecting xylem HF to cell death has not been identified yet. The main aim of this study was to evaluate, at the leaf level, the relationship between loss of hydraulic function due to cavitation and cell death under drought conditions and discern how this relationship varied across species with contrasting resistances to cavitation. Drought was induced by withholding water from potted seedlings, and their leaves were sampled to measure their relative water content (RWC) and cell mortality. Vulnerability curves to cavitation at the leaf level were constructed for each species. An increment in cavitation events occurrence precedes the onset of cell mortality. A variation in cells tolerance to dehydration was observed along with the resistance to cavitation. Overall, our results indicate that the onset of cellular mortality occurs at lower RWC than the one for cavitation indicating the role of cavitation in triggering cellular death. They also evidenced a critical RWC for cellular death varying across species with different cavitation resistance.

Plant hydraulic modelling of leaf and canopy fuel moisture content reveals increasing vulnerability of a Mediterranean forest to wildfires under extreme drought.

Fuel moisture content (FMC) is a crucial driver of forest fires in many regions world-wide. Yet, the dynamics of FMC in forest canopies as well as their physiological and environmental determinants remain poorly understood, especially under extreme drought. We embedded a FMC module in the trait-based, plant-hydraulic SurEau-Ecos model to provide innovative process-based predictions of leaf live fuel moisture content (LFMC) and canopy fuel moisture content (CFMC) based on leaf water potential ( ψ Leaf ). SurEau-Ecos-FMC relies on pressure-volume (p-v) curves to simulate LFMC and vulnerability curves to cavitation to simulate foliage mortality. SurEau-Ecos-FMC accurately reproduced ψ Leaf and LFMC dynamics as well as the occurrence of foliage mortality in a Mediterranean Quercus ilex forest. Several traits related to water use (leaf area index, available soil water, and transpiration regulation), vulnerability to cavitation, and p-v curves (full turgor osmotic potential) had the greatest influence on LFMC and CFMC dynamics. As the climate gets drier, our results showed that drought-induced foliage mortality is expected to increase, thereby significantly decreasing CFMC. Our results represent an important advance in our capacity to understand and predict the sensitivity of forests to wildfires.

Experiencias del telemonitoreo en pacientes con COVID-19

La COVID-19 genera síntomas respiratorios que pueden causar cuadros de mayor severidad en pacientes con factores de riesgo, por lo que es necesario realizar una detección y atención temprana. En un contexto de aislamiento social y gran demanda de los servicios de salud uno de los métodos de seguimiento desarrollado últimamente es la telemonitorización que permite la vigilancia remota de los pacientes. El objetivo de la investigación fue realizar una revisión panorámica sobre las diferentes experiencias en cuanto a telemonitoreo de pacientes con COVID-19 a nivel nacional e internacional. Se revisaron artículos en inglés y español publicados desde el 1 de enero de 2020 hasta el 7 de mayo de 2022 en los sitios de búsqueda PubMed, SciELO y Google Scholar. La indagación se ejecutó con las palabras clave "telemonitoreo", "pacientes", "COVID-19" y "pandemia". De los 160 artículos encontrados, se descartaron cuatro que estaban duplicados y 126 por no tener relación directa con el tema. De los 30 seleccionados, 24 contaban con resultados de investigación y seis se emplearon para los aspectos teórico-conceptuales relacionados con el objetivo del estudio. La implementación del monitoreo remoto para el seguimiento de pacientes con diagnóstico confirmado o sospechoso de COVID-19 ha demostrado ser factible, de bajo costo, estar al alcance del paciente y del personal médico. Asimismo, la monitorización remota reduce el uso de los recursos hospitalarios e identifica oportunamente el progreso de la enfermedad. Actualmente, aún faltan estudios prospectivos-analíticos que permitan determinar con precisión lo que se podría mejorar en los sistemas de atención remota.

COVID-19 generates respiratory symptoms that can cause more severe symptoms in patients with risk factors, so early detection and care is necessary. In a context of social isolation and high demand for health services, one of the recently developed monitoring methods is telemonitoring, which allows remote surveillance of patients. The objective of the research was to perform a panoramic review of the different experiences regarding telemonitoring of patients with COVID-19 at national and international level. Articles in English and Spanish published from January 1, 2020 to May 7, 2022 in the PubMed, SciELO and Google Scholar search sites were reviewed. The search was performed with the keywords "telemonitoring", "patients", "COVID-19" and "pandemic". Of the 160 articles found, four were discarded because they were duplicates and 126 because they were not directly related to the topic. Of the 30 selected, 24 had research results and six were used for theoretical-conceptual aspects related to the objective of the study. The implementation of remote monitoring for the follow-up of patients with a confirmed or suspected diagnosis of COVID-19 has proven to be feasible, low cost, within the reach of the patient and medical personnel. Also, remote monitoring reduces the use of hospital resources and identifies disease progression in a timely manner. At present, prospective-analytical studies are still lacking to determine precisely what could be improved in remote care systems.

Impacto de la retinopatía hipertensiva asociada a cardiopatías coronarias

Introducción: La asociación entre la retinopatía hipertensiva y cardiopatías coronarias es un tema de una larga controversia. La retinopatía hipertensiva ha sido definida como un predictor de mortalidad y morbilidad en pacientes hipertensos desde hace mucho tiempo. Además, estudios recientes han demostrado que la microvasculatura retiniana refleja la patología en los pequeños vasos sistémicos, incluida la microcirculación coronaria. Objetivos: El objetivo fue realizar una revisión sistemática y un análisis cualitativo y cuantitativo mediante un metanálisis para determinar la asociación entre la retinopatía hipertensiva y cardiopatías coronarias. Métodos: Se realizó la búsqueda sistemática de estudios relacionados con el tema. La fuente de búsqueda fue PubMed y Google Scholar. La revisión sistemática y meta-análisis se desarrollaron con las pautas Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). Resultados: Se demostró que existe una asociación entre la retinopatía hipertensiva y la enfermedad de la arteria coronaria. (P=0,01; RR 1,29; IC 95 %: 1,06 a 1,56), se evaluó la hipertrofia ventricular izquierda como desenlace, se encontró un efecto estadísticamente significativo que asocia a la retinopatía hipertensiva con la hipertrofia ventricular izquierda (p=0,03; RR: 1,71; IC 95 %: 1,31 a 2,24). Conclusiones: Se encontró asociación entre retinopatía hipertensiva y las cardiopatías coronarias más frecuentes (Enfermedad coronaria e HVI).

Introduction: The association between hypertensive retinopathy and coronary heart disease is a subject of long-standing controversy. Hypertensive retinopathy has long been defined as a predictor of mortality and morbidity in hypertensive patients. In addition, recent studies have shown that the retinal microvasculature reflects pathology in small systemic vessels, including the coronary microcirculation. Objectives: The aim was to perform a systematic review and a qualitative and quantitative analysis by meta-analysis to determine the association between hypertensive retinopathy and coronary heart disease. Methods: A systematic search for studies related to the topic was performed. The search source was PubMed and Google Scholar. The systematic review and meta-analysis were developed using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Results: An association between hypertensive retinopathy and coronary artery disease was demonstrated (P=0.01; RR 1.29; 95 % CI: 1.06 to 1.56), left ventricular hypertrophy was evaluated as an outcome, a statistically significant effect was found associating hypertensive retinopathy with left ventricular hypertrophy (P=0.03; RR: 1.71; 95 % CI: 1.31 to 2.24). Conclusions: An association was found between hypertensive retinopathy and the most frequent coronary heart diseases (coronary artery disease and LVH).

Curcuma longa: eficacia en el tratamiento de osteoatritis en adultos / Eficácia da cúrcuma no tratamento da osteoartrite em pacientes adultos / Effectiveness of turmeric in the treatment of osteoarthritis in adult patients

Introducción: La osteoartritis (OA) es una de las principales causas de dolor y discapacidad a nivel mundial. El tratamiento convencional son los analgésicos y antiinflamatorios no esteroideos (AINE), relacionados con efectos adversos gastrointestinales y cardiovasculares, motivo que hace necesaria la búsqueda de nuevas herramientas terapéuticas. Objetivo: Revisión de los últimos años de las diversas publicaciones científicas acerca de la eficacia de la cúrcuma (Curcuma longa) en el tratamiento de pacientes con osteoartritis. Métodos: Revisión sistemática a través de la búsqueda electrónica que incluyó PubMed, ProQuest, Google Scholar desde 9 de enero del2018 hasta 24 de mayo de 2021.Resultados: De los 81 artículos encontrados, se descartaron 70 porno cumplir con nuestros criterios, quedando 11 para la revisión sistemática. Conclusión: Los ensayos clínicos analizados muestran que el tratamiento con diferentes preparados de cúrcuma tiene eficacia similar a los AINEs, pero con menos efectos adversos, lo que lo sugiere como alternativa analgésica y antiinflamatoria. Sin embargo, las limitaciones metodológicas de los mismos hacen necesaria la realización de estudios más rigurosos antes de recomendarla como terapia eficaz para la osteoartritis de rodilla. (AU)

Introdução: A osteoartrite (OA) é uma das principais causas de dor e incapacidade em todo o mundo. O tratamento convencional recorre a analgésicos e antiinflamatórios não esteróides (AINEs), que estão relacionados com efeitos adversos gastrointestinais e cardiovasculares, o que tornanecessária a procura de novas estratégias terapêuticas. Objetivo: Rever as diversas publicações científicas dos últimos anos sobre a eficácia da cúrcuma (Curcuma longa) no tratamento de pacientes com osteoartrite. Métodos: Revisão sistemática através de pesquisa eletrónica que incluiu PubMed, ProQuest, Google Scholar de 9 de janeiro de 2018 a 24 de maio de 2021.Resultados: Dos 81 artigos encontrados, 70 foram descartados por não atenderem aos nossos critérios, restando 11para revisão sistemática. Conclusão: Os ensaios clínicos analisados mostram que otratamento com diferentes preparações de cúrcuma temeficácia semelhante aos AINEs, porém com menos efeitos adversos, o que o sugere como alternativa analgésica e anti-inflamatória. No entanto, suas limitações metodológicas tornam necessária uma realização de estudos mais rigorosos antes de a recomendar como uma terapia alternativa eficaz para a osteoartrite do joelho. (AU)

Introduction: Osteoarthritis (OA) is one of the main causes of pain and disability worldwide. The traditional treatment uses analgesic and non-steroidal anti-inflammatory drugs (NSAIDs), which are related to gastrointestinal and cardiovascular adverse effects, which makes necessary the search for new therapeutic tools. Objective: Review of the last years scientific publications about the efficacy of turmeric (Curcuma longa) in the treatment of patients with osteoarthritis. Methods: Systematic review through the electronic search in PubMed, ProQuest, Google Scholar from January 9, 2018 to May 24, 2021. Results: Out of the 81 articles found, 70 were discarded because did not meet our criteria, leaving 11 for systematic review. Conclusion: The clinical trials analyzed have shown that treatment with different turmeric preparations has similar efficacy to NSAIDs, but with less adverse effects, which suggests it as an analgesic and anti-inflammatory alternative. However, due to the methodological limitations of existing studies, more rigorous trials are needed beforere commending it as an effective therapy for knee osteoarthritis. (AU)

No cumplimiento del esquema de vacunación nacional en niños menores de 5 años en la selva peruana en el año 2019

Introducción: Se ha visto un decaimiento de la cobertura de vacunas en niños residentes de Perú, menores de cinco años; siendo la región selva la más afectada. Objetivo: Analizar los factores sociales y maternos asociados al no cumplimiento del esquema nacional de vacunación en menores de cinco años en la selva peruana, año 2019. Métodos: Estudio observacional, analítico y retrospectivo. Se utilizó la base de la Encuesta Demográca y de Salud Familiar (ENDES) Perú, 2019. Se seleccionaron las variables de estudio y se utilizó el programa SPSS 26,0 para el análisis. De 4 373 encuestas seleccionadas se evidenció que el 57,5% de niños menores de cinco años de la selva peruana no cumplieron con el esquema nacional de vacunación (ENV); los factores asociados fueron pobreza (RPa=1,18, p<0,001, IC95% 1,08-1,29), lengua materna nativa (RPa=1,17, p<0,001. IC95% 1,07-1,30), problemas para acudir al centro de salud (RPa=1,09, p=0,036, IC95% 1,04-1,21), edad menor a 24 años de madre/apoderado (RPa=0,78, p<0,001, IC95% 0,68-0,89) y no tener seguro de salud (RPa 1,2; p<0,000, IC95% 1,11-1,29). Conclusión: Los factores de riesgo sociales, pobreza (RPa=1,18, p<0,001, IC95% 1,08-1,29) y lengua materna nativa (RPa=1,17, p<0,001. IC95% 1,07-1,30); y los factores de riesgo maternos, problemas para acudir al centro de salud (RPa=1,09, p=0,036, IC95% 1,04-1,21), edad menor a 24 años de madre/apoderado (RPa=0,78, p<0,001, IC95% 0,68-0,89) y no tener seguro de salud (RPa 1,2; p<0,000, IC95% 1,11-1,29), se asociaron a no cumplimiento del ENV.

Introduction: A decline in vaccine coverage has been seen in children living in Peru, under ve years of age; being the jungle region the most affected. Objective: Analyze the social and maternal factors associated with non-compliance with the national vaccination scheme in children under ve years of age in the Peruvian jungle, year 2019. Methods: Observational, analytical and retrospective study. The base of the Demographic and Family Health Survey (ENDES) Peru, 2019 was used. The study variables were selected and the SPSS 26.0 program was used for the analysis. From 4,373 selected surveys, it was shown that 57.5% of children under ve years of age in the Peruvian jungle had non-compliance with the national vaccination scheme (ENV); the associated factors were not having health insurance (RPa 1.2; p<0.000, CI95% 1.11-1.29), poverty (RPa=1.18, p<0.001, CI95% 1.08-1, 29), native mother tongue (RPa=1.17, p<0.001. CI95% 1.07-1.30), problems going to the health center (RPa=1.09, p=0.036, CI95% 1, 04-1.21), and mother/guardian age under 24 years (RPa=0.78, p<0.001, 95% CI 0.68-0.89). Conclusion: The risk factors associated with non-compliance with the ENV were: social, not having health insurance (RPa 1.2; p<0.000, CI95% 1.11-1.29), poverty (RPa=1.18, p< 0.001, 95% CI 1.08-1.29) and native mother tongue (RPa=1.17, p<0.001. 95% CI 1.07-1.30); and maternal, problems going to the health center (RPa=1.09, p=0.036, 95% CI 1.04-1.21), and mother/guardian age under 24 years (RPa=0.78, p <0.001, 95% CI 0.68-0.89).

Noncompliance with the national vaccination scheme in children in the peruvian jungle, year 2019 / No cumplimiento del esquema nacional de vacunación en niños de la selva peruana, año 2019

En los últimos años a nivel nacional se ha visto un decaimiento de la cobertura en niños menores de 5 años siendo la región selva la más afectada. El presente estudio tuvo como objetivo analizar los factores maternos y sociales asociados al no cumplimiento del esquema de vacunación nacional en niños de 1 a 5 años en la selva peruana en el año 2019, con diseño observacional, analítico empleando la base de datos de la Encuesta Demográfica y de Salud Familiar-(ENDES) 2019 comprendiendo los menores de 5 años en Perú en ese mismo año, se seleccionaron las variables de estudio y se utilizó el programa SPSS 26.0 para el análisis. Fueron 4373 encuestas seleccionadas; se evidenció que el 57.5% de 1 a 5 años tienen el esquema de vacunación incompleto, cuyos factores asociados fueron no tener seguro de salud (ORa 1.72; p<0,01, IC95% 1,39-2,13), la pobreza (ORa=1,427, p<0,01, IC95% 1,89-1,71), lengua materna nativa (ORa=1,50, p<0,01, IC95% 1,13-2,0), problemas para acudir al centro de salud[1] (ORa=1,213, p=0,02, IC95% 1,02-1,44), vivir fuera de la ciudad (ORa= 1,31, p<0,01, IC95% 1,09- 1,58), edad menor a 24 años de madre/apoderado (ORa=1,38, p<0,01, IC95% 1,186-1,619). Lo que indica una asociación estadísticamente significativa entre algunos de los factores maternos y sociales estudiados con el no cumplimiento del esquema nacional de vacunación.

In the past decade, levels of coverage on children vaccination had been decreasing nationwide, even more in the Peruvian jungle, reason why is an important public health's subject to attend. The purpose of this investigation was to analyze maternal and social factors that are associated with incomplete vaccination schedules on children under 5 years old on the Peruvian jungle. It is an observational, analytic investigation, using a secondary source from the Demographic and Family survey (ENDES) from 2019, where is found the information of all the under 5 years old with the healthcare card of oral information given by the mother. Then after selecting the chosen variables, we used the SPSS statistic program for the posterior analysis. Of the 4373 surveys studied; it was shown that 57.5% of children under 5 years have the incomplete vaccination schedule. The multivariate analysis found that non-compliance with the vaccination schedule associated with maternal and social factors such as not having health insurance (ORa 1.72; p<0.01, IC95% 1.39-2,13), poverty (ORa-1,427, p<0.01, IC95% 1.89-1.71), native mother tongue (ORa-1.50, p<0.01, IC-1.13-2,0), problems attending the health center (ORa-1,213, p=0.02, IC95% 1.02-1.44), live outside the city (ORa-1.31, p<0.01, IC95% 1.09- 1.58), age under the age of 24 as a mother/guardian (ORa-1.38, p<0.01, IC95% 1,186-1,619). Not having health insurance, living in poverty, having trouble going to the health center, living outside the city, having a different mother tongue than Spanish and age under 24 are factors associated with non-compliance with the vaccination schedule.