Predictive value of dynamic arterial elastance for vasopressor withdrawal: a systematic review and meta-analysis.

BACKGROUND: Dynamic arterial elastance (Eadyn) has been investigated for its ability to predict hypotension during the weaning of vasopressors. Our study focused on assessing Eadyn's performance in the context of critically ill adult patients admitted to the intensive care unit, regardless of diagnosis. MAIN BODY: Our study was conducted in accordance with the Preferred Reported Items for Systematic Reviews and Meta-Analysis checklist. The protocol was registered in PROSPERO (CRD42023421462) on May 26, 2023. We included prospective observational studies from the MEDLINE and Embase databases through May 2023. Five studies involving 183 patients were included in the quantitative analysis. We extracted data related to patient clinical characteristics, and information about Eadyn measurement methods, results, and norepinephrine dose. Most patients (76%) were diagnosed with septic shock, while the remaining patients required norepinephrine for other reasons. The average pressure responsiveness rate was 36.20%. The synthesized results yielded an area under the curve of 0.85, with a sensitivity of 0.87 (95% CI 0.74-0.93), specificity of 0.76 (95% CI 0.68-0.83), and diagnostic odds ratio of 19.07 (95% CI 8.47-42.92). Subgroup analyses indicated no variations in the Eadyn based on norepinephrine dosage, the Eadyn measurement device, or the Eadyn diagnostic cutoff to predict cessation of vasopressor support. CONCLUSIONS: Eadyn, evaluated through subgroup analyses, demonstrated good predictive ability for the discontinuation of vasopressor support in critically ill patients.

Motor Intentions Decoded from fMRI Signals.

Motor intention is a high-level brain function related to planning for movement. Although studies have shown that motor intentions can be decoded from brain signals before movement execution, it is unclear whether intentions relating to mental imagery of movement can be decoded. Here, we investigated whether differences in spatial and temporal patterns of brain activation were elicited by intentions to perform different types of motor imagery and whether the patterns could be used by a multivariate pattern classifier to detect such differential intentions. The results showed that it is possible to decode intentions before the onset of different types of motor imagery from functional MR signals obtained from fronto-parietal brain regions, such as the premotor cortex and posterior parietal cortex, while controlling for eye movements and for muscular activity of the hands. These results highlight the critical role played by the aforementioned brain regions in covert motor intentions. Moreover, they have substantial implications for rehabilitating patients with motor disabilities.

IFN-γ-Preconditioned Human Gingival-Derived Mesenchymal Stromal Cells Inhibit Plasmacytoid Dendritic Cells via Adenosine.

Plasmacytoid dendritic cells (pDCs) are vital players in antiviral immune responses because of their high levels of IFN-α secretion. However, this attribute has also implicated them as critical factors behind the immunopathogenesis of inflammatory diseases, and no currently available therapy can efficiently inhibit pDCs' aberrant activation. Mesenchymal stromal cells (MSCs) possess stromal immunomodulatory functionality, regulating immune cell activation through several mechanisms, including the adenosinergic (CD39/CD73/adenosine) pathway. The IFN-γ preconditioning of bone marrow MSCs improves their inhibitory properties for therapy applications; however, isolating human gingival tissue-derived MSCs (hGMSCs) is more accessible. These cells have shown better immunomodulatory effects, yet the outcome of IFN-γ preconditioning and its impact on the adenosinergic pathway has not been evaluated. This study first validated the immunoregulatory properties of primary-cultured hGMSCs, and the results showed that IFN-γ preconditioning strengthens CD39/CD73 coexpression, adenosine production, and the regulatory properties of hGMSC, which were confirmed by describing for the first time their ability to reduce pDC activation and their IFN-α secretion and to increase the frequency of CD73+ pDC. In addition, when CD73's enzymatic activity was neutralized in hGMSCs, adenosine production and the IFN-γ preconditioning effect were restrained. This evidence might be applied to design hGMSCs- and adenosine-based immunotherapeutic strategies for treating inflammatory disorders that are associated with pDC overactivation.

Detection of Asymptomatic Sickle Cell Hemoglobin Carriers and Fetal Hemoglobin Regulating Genetic Variants in African Descendants from Oaxaca, Mexico.

Sickle cell anemia has been classified as a noninfectious neglected tropical disease and, although not exclusively, affects African descendants more frequently. This study aimed to detect asymptomatic sickle cell hemoglobin carriers (HbAS) in marginalized and vulnerable populations during a public health screening in African descendants from Oaxaca, Mexico, and to validate an amplification refractory mutation system (ARMS)-PCR methodology to detect fetal-hemoglobin (HbF)-regulating genetic variants in BCL11A toward affordable routine association of single nucleotide variants (SNVs) with HbF concentrations. To this aim, hemoglobin variants were detected by acidic citrate agar and alkaline cellulose acetate electrophoreses. SNVs in the hemoglobin subunit beta gene (HBB) were identified by the ß-globin mutation detection assay (ß-GMDA) and ARMS-PCR, respectively, and validated by Sanger sequencing. The association between genotypes and HbF concentrations was evaluated using Spearman's correlation coefficient. The results obtained during a directed screening in 140 self-identified African descendants revealed 42 HbS-carriers (30%), of which 39 showed normal total hemoglobin concentrations (92.8%), only 3 presented anemia (7.2%), and 9 showed quantifiable HbF concentration (21.4%). As validated by Sanger sequencing, the designed ARMS-PCR efficiently detected homozygous and heterozygous variants in BCL11A. In a cohort of 42 heterozygous (HbAS) and 27 healthy (HbAA) individuals from the same population, only one SNV (rs766432) showed statistically significant association with increasing HbF concentration, and two new unrelated homozygous silent variants were identified. This study reveals the need to raise coverage of HbS screening in vulnerable populations and shows a feasible low-cost ARMS-PCR methodology to determine the presence of SNVs in quantitative trait loci affecting HbF.

Nucleus segmentation of white blood cells in blood smear images by modeling the pixels' intensities as a set of three Gaussian distributions.

The precise segmentation of white blood cells (WBCs) within blood smear images is a significant challenge with implications for both medical research and image processing. Of particular importance is the often neglected task of accurately segmenting WBC nuclei, an aspect that currently lacks dedicated methodologies. This paper introduces a straightforward and efficient method designed to fill this critical gap, providing an effective solution for the efficient segmentation of WBC nuclei. In blood smear imagery, the distinctive coloration of WBCs contrasts with the hues of other blood components. The inherent obscurity of WBCs prompts their segmentation by isolating pixels with minimal intensities. To streamline this process, our proposed method employs the Laplacian pyramid technique to decorrelate pixels in blood smear images, thereby amplifying the contrast. Subsequently, the intensities of pixels constituting blood cells, encompassing WBCs and the background, are modeled using three Gaussian random variables. Capitalizing on this feature, we implement the Gaussian mixture model (GMM) clustering method to determine the optimal threshold value, facilitating a highly precise segmentation of WBC nuclei. The proposed method demonstrates the capability to process images containing a single WBC as well as effectively functioning with images containing multiple cells of this type. Evaluation of the method on the ALL-IDB, ALL-IDB2, CellaVision, and JTSC datasets yielded accuracy values of 0.9802, 0.9725, 0.9772, and 0.9730, respectively. Comparative analysis with state-of-the-art methods revealed a notably comparable performance, underscoring the effectiveness of the proposed approach. The method presented in this article is highly competitive for segmenting the nuclei of WBCs compared to state-of-the-art methods. The three main advantages of our method are its ability to process images containing one or more WBCs, the automatic calculation of threshold values for each processed image, eliminating the need for manual parameter adjustments. Lastly, the method is efficient, as its algorithmic complexity is approximately O ( n m ) .

Trasplante cardíaco por hemocromatosis. Caso pediátrico / Cardiac transplantation due to hemochromatosis. A pediatric case report

La hemocromatosis es una enfermedad caracterizada por el excesivo depósito de hierro en múltiples órganos, entre ellos hígado, páncreas, piel y corazón. La infiltración de este último es un importante factor en morbilidad y mortalidad. Presentamos un caso de un paciente pediátrico con insuficiencia cardíaca terminal que ameritó trasplante cardíaco, que resultó sin complicaciones. Posterior a la cirugía, mostró mejoría bioquímica y clínica, lo que influyó positivamente en su calidad de vida y prolongó su supervivencia.

Hemochromatosis is a disease characterized by excess iron stores in multiple organs, including the liver, pancreas, skin, and heart. The infiltration of the heart is an important factor in morbidity and mortality. Here we describe the case of a pediatric patient with end-stage heart failure who required a heart transplantation, with no complications. After the surgery, she showed biochemical and clinical improvement, with a positive impact on her quality of life and a prolonged survival.

Quantitative Proteomics for the Identification of Differentially Expressed Proteins in the Extracellular Vesicles of Cervical Cancer Cells.

The extracellular vesicles (EVs) in a tumoral microenvironment can exert different functions by transferring their content, which has been poorly described in cervical cancer. Here, we tried to clarify the proteomic content of these EVs, comparing those derived from cancerous HPV (+) keratinocytes (HeLa) versus those derived from normal HPV (-) keratinocytes (HaCaT). We performed a quantitative proteomic analysis, using LC-MS/MS, of the EVs from HeLa and HaCaT cell lines. The up- and downregulated proteins in the EVs from the HeLa cell line were established, along with the cellular component, molecular function, biological processes, and signaling pathways in which they participate. The biological processes with the highest number of upregulated proteins are cell adhesion, proteolysis, lipid metabolic process, and immune system processes. Interestingly, three of the top five signaling pathways with more up- and downregulated proteins are part of the immune response. Due to their content, we can infer that EVs can have a significant role in migration, invasion, metastasis, and the activation or suppression of immune system cells in cancer.

Cardiac transplantation due to hemochromatosis. A pediatric case report. / Trasplante cardíaco por hemocromatosis. Caso pediátrico.

Hemochromatosis is a disease characterized by excess iron stores in multiple organs, including the liver, pancreas, skin, and heart. The infiltration of the heart is an important factor in morbidity and mortality. Here we describe the case of a pediatric patient with end-stage heart failure who required a heart transplantation, with no complications. After the surgery, she showed biochemical and clinical improvement, with a positive impact on her quality of life and a prolonged survival.

La hemocromatosis es una enfermedad caracterizada por el excesivo depósito de hierro en múltiples órganos, entre ellos hígado, páncreas, piel y corazón. La infiltración de este último es un importante factor en morbilidad y mortalidad. Presentamos un caso de un paciente pediátrico con insuficiencia cardíaca terminal que ameritó trasplante cardíaco, que resultó sin complicaciones. Posterior a la cirugía, mostró mejoría bioquímica y clínica, lo que influyó positivamente en su calidad de vida y prolongó su supervivencia.

Prevalence of gestational diabetes and gestational hypertension in pregnant women with pregestational obesity / Prevalencia de diabetes e hipertensión gestacional en embarazadas con obesidad pregestacional

Resumen OBJETIVO: Describir la prevalencia de diabetes gestacional e hipertensión arterial en pacientes embarazadas con obesidad pregestacional. MATERIALES Y MÉTODOS: Estudio retrospectivo, transversal y descriptivo llevado a cabo en mujeres embarazadas con diagnóstico previo de obesidad (índice de masa corporal superior a 29.99) y con control prenatal. Parámetros evaluados: estilo de vida (alimentación, actividad física, consumo de alcohol, tabaco o alguna toxicomanía) y características físicas, clínicas y bioquímicas durante el embarazo actual por trimestre (índice de masa corporal, glucosa, presión arterial sistólica y diastólica). El diagnóstico de diabetes gestacional se estableció mediante una prueba de tolerancia a la glucosa entre las semanas 24 y 28 de embarazo. La hipertensión gestacional se diagnosticó por cifras de presión arterial mayores e iguales a 140-90 mmHg a partir de la semana 20 de embarazo y en ausencia de proteinuria. El análisis estadístico incluyó porcentajes, promedios e intervalos de confianza. RESULTADOS: La prevalencia de diabetes gestacional en embarazadas con obesidad fue 13.7% (IC95%: 9.6 a 17.9) y la de hipertensión gestacional en embarazadas con obesidad 7.4% (IC95%: 4.3 a 10.6). CONCLUSIÓN: La obesidad es un factor conocido de riesgos, en particular de diabetes e hipertensión en el embarazo. Su alta prevalencia hace necesario implementar campañas de prevención que favorezcan su reducción.

Abstract OBJECTIVE: To describe the prevalence of gestational diabetes and arterial hypertension in pregnant patients with pre-pregnancy obesity. MATERIALS AND METHODS: Retrospective, cross-sectional and descriptive study in pregnant women with a diagnosis of obesity prior to pregnancy (body mass index greater than 29.99) and with prenatal care. The sample size was 269 pregnant women. Lifestyle (diet, physical activity, alcohol, tobacco or drug addiction) and physical, clinical and biochemical characteristics during the current pregnancy were evaluated by gestational trimester (body mass index, glucose, systolic and diastolic blood pressure). The diagnosis of gestational diabetes was established by a glucose tolerance test between the 24th and 28th week of gestation and gestational hypertension was diagnosed by blood pressure figures greater than or equal to 140/90 mmHg from the 20th week of gestation and in the absence of proteinuria. Statistical analysis included percentages, means, and confidence intervals. RESULTS: The prevalence of gestational diabetes in obese pregnant women was 13.7% (95%CI: 9.6-17.9) and the prevalence of gestational hypertension in obese pregnant women was 7.4% (95%CI: 4.3-10.6). CONCLUSION: Obesity is a known risk factor, particularly for diabetes and hypertension in pregnancy. Its high prevalence makes it necessary to implement prevention campaigns to reduce it.

Allowing access to parents/caregivers into COVID-19 hospitalization areas does not increase infections among health personnel in a pediatric hospital.

Background: At the beginning of the current COVID-19 pandemic, it became critical to isolate all infected patients, regardless of their age. Isolating children has a negative effect on both, them and their parents/caregivers. Nevertheless isolation was mandatory because of the potential risk that visitation might have on COVID-19 dissemination mostly among health personnel. Methods: From the starting of the COVID-19 pandemic in our pediatric hospital visits were forbidden. This 2 months period (April-May) was called P1. In June parents were allowed to visit (P2), under a visiting protocol previously published. Hospital workers were monitored for the presence of COVID-19 symptoms and tested for the infection when clinically justified. The positivity proportion and the relative risk (RR) of COVID-19 among the health personnel between periods were calculated. The caregivers were also followed up by phone calls. Results: Since April 2020 to November 2020, 2,884 health personnel were studied for 234 days, (318,146 workers days). Although the COVID-19/1,000 health personnel days rate decreased from one period to another (1.43 vs 1.23), no statistically significant differences were found. During P1, 16 patients with COVID-19 were treated. During the follow up none of the family members were infected/symptomatic in P1, while in P2, 6/129 (4.65%) were symptomatic or had a positive test. All of them initiated between 2 and 4 days after the patient's admission. As they also had some other infected family members it was not possible to ensure the source of infection. There were no statistically significant differences in the RR of COVID-19 in health personnel, (RR 1, 95% CI 0.69-1.06, p = 0.162). Conclusions: When safely implemented, allowing parents/caregivers to spend time with their hospitalized COVID-19 children does not increase the contagion risk for hospital workers or among themselves.

A real-time fMRI neurofeedback system for the clinical alleviation of depression with a subject-independent classification of brain states: A proof of principle study.

Most clinical neurofeedback studies based on functional magnetic resonance imaging use the patient's own neural activity as feedback. The objective of this study was to create a subject-independent brain state classifier as part of a real-time fMRI neurofeedback (rt-fMRI NF) system that can guide patients with depression in achieving a healthy brain state, and then to examine subsequent clinical changes. In a first step, a brain classifier based on a support vector machine (SVM) was trained from the neural information of happy autobiographical imagery and motor imagery blocks received from a healthy female participant during an MRI session. In the second step, 7 right-handed female patients with mild or moderate depressive symptoms were trained to match their own neural activity with the neural activity corresponding to the "happiness emotional brain state" of the healthy participant. The training (4 training sessions over 2 weeks) was carried out using the rt-fMRI NF system guided by the brain-state classifier we had created. Thus, the informative voxels previously obtained in the first step, using SVM classification and Effect Mapping, were used to classify the Blood-Oxygen-Level Dependent (BOLD) activity of the patients and converted into real-time visual feedback during the neurofeedback training runs. Improvements in the classifier accuracy toward the end of the training were observed in all the patients [Session 4-1 Median = 6.563%; Range = 4.10-27.34; Wilcoxon Test (0), 2-tailed p = 0.031]. Clinical improvement also was observed in a blind standardized clinical evaluation [HDRS CE2-1 Median = 7; Range 2 to 15; Wilcoxon Test (0), 2-tailed p = 0.016], and in self-report assessments [BDI-II CE2-1 Median = 8; Range 1-15; Wilcoxon Test (0), 2-tailed p = 0.031]. In addition, the clinical improvement was still present 10 days after the intervention [BDI-II CE3-2_Median = 0; Range -1 to 2; Wilcoxon Test (0), 2-tailed p = 0.50/ HDRS CE3-2 Median = 0; Range -1 to 2; Wilcoxon Test (0), 2-tailed p = 0.625]. Although the number of participants needs to be increased and a control group included to confirm these findings, the results suggest a novel option for neural modulation and clinical alleviation in depression using noninvasive stimulation technologies.

Variability in Susceptibility to Type I Interferon Response and Subgenomic RNA Accumulation Between Clinical Isolates of Dengue and Zika Virus From Oaxaca Mexico Correlate With Replication Efficiency in Human Cells and Disease Severity.

Dengue and Zika viruses cocirculate annually in endemic areas of Mexico, causing outbreaks of different magnitude and severity every year, suggesting a continuous selection of Flavivirus variants with variable phenotypes of transmissibility and virulence. To evaluate if Flavivirus variants with different phenotypes cocirculate during outbreaks, we isolated dengue and Zika viruses from blood samples of febrile patients from Oaxaca City during the 2016 and 2019 epidemic years. We compared their replication kinetics in human cells, susceptibility to type I interferon antiviral response, and the accumulation of subgenomic RNA on infected cells. We observed correlations between type I interferon susceptibility and subgenomic RNA accumulation, with high hematocrit percentage and thrombocytopenia. Our results suggest that Flaviviruses that cocirculate in Oaxaca, Mexico, have variable sensitivity to the antiviral activity of type I interferons, and this phenotypic trait correlates with the severity of the disease.

Human Platelets Contain, Translate, and Secrete Azurocidin; A Novel Effect on Hemostasis.

Platelets play a significant role in hemostasis and perform essential immune functions, evidenced by the extensive repertoire of antimicrobial molecules. Currently, there is no clear description of the presence of azurocidin in human platelets. Azurocidin is a 37 kDa cationic protein abundant in neutrophils, with microbicidal, opsonizing, and vascular permeability-inducing activity. Therefore, this work aimed to characterize the content, secretion, translation, and functions of azurocidin in platelets. Our results show the presence of azurocidin mRNA and protein in α-granules of platelet and megakaryoblasts, and stimulation with thrombin, ADP, and LPS leads to the secretion of free azurocidin as well as within extracellular vesicles. In addition, platelets can translate azurocidin in a basal or thrombin-induced manner. Finally, we found that the addition of low concentrations of azurocidin prevents platelet aggregation and activation. In conclusion, we demonstrate that platelets contain, secrete, and translate azurocidin, and this protein may have important implications for hemostasis.

miRNAs Contained in Extracellular Vesicles Cargo Contribute to the Progression of Idiopathic Pulmonary Fibrosis: An In Vitro Aproach.

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive lung disease. Lesions in the lung epithelium cause alterations in the microenvironment that promote fibroblast accumulation. Extracellular vesicles (EVs) transport proteins, lipids, and nucleic acids, such as microRNAs (miRNAs). The aim of this study was to characterize the differentially expressed miRNAs in the cargo of EVs obtained from the LL97 and LL29 fibroblast cell lines isolated from IPF lungs versus those derived from the CCD19 fibroblast cell line isolated from a healthy donors. We characterized EVs by ultracentrifugation, Western blotting, and dynamic light scattering. We identified miRNAs by small RNA-seq, a total of 1144 miRNAs, of which 1027 were known miRNAs; interestingly, 117 miRNAs were novel. Differential expression analysis showed that 77 miRNAs were upregulated and 68 were downregulated. In addition, pathway enrichment analyses from the Gene Ontology and Kyoto Encyclopedia of Genomes identified several miRNA target genes in the categories, cell proliferation, regulation of apoptosis, pathways in cancer, and proteoglycans in cancer. Our data reveal that miRNAs contained in EVs cargo could be helpful as biomarkers for fibrogenesis, diagnosis, and therapeutic intervention of IPF.

El impacto de la resiliencia en la esquizofrenia: una revisión sistemática cualitativa / The impact of resilience in Schizophrenia: a qualitative systematic review

Resumen Introducción: la resiliencia ha sido definida como la resistencia frente a experiencias psicosociales adversas. Tiene un rol importante en varios trastornos mentales, asociándose, por ejemplo, a la severidad en el trastorno depresivo mayor y a la calidad de vida en el trastorno afectivo bipolar. La esquizofrenia es un trastorno mental severo que destaca por producir dificultades en múltiples dominios de la vida y una alta morbimortalidad. El objetivo de esta revisión fue sintetizar la evidencia disponible acerca de la importancia de la resiliencia en la esquizofrenia. Métodos: se realizó una búsqueda en las bases de datos PubMed, LILACS y SciELO, seleccionando artículos en inglés y español, que incluyeran personas con esquizofrenia y midieran la resiliencia. Veinticinco artículos cumplieron los criterios de inclusión. Resultados: las personas con esquizofrenia tenían una menor resiliencia que sujetos sanos (9 estudios). El nivel de resiliencia se asoció inversamente con los síntomas negativos (3 estudios), síntomas positivos (1 estudio), depresión (4 estudios), desesperanza (3 estudios) y suicidio (1 estudio). Por otro lado, la resiliencia se asoció positivamente con la calidad de vida (5 estudios), funcionalidad (4 estudios) y salud física (2 estudios). En dos estudios se evaluaron intervenciones orientadas a potenciar la resiliencia de pacientes con esquizofrenia, mostrando resultados poco concluyentes. Discusión: es llamativa la escasa literatura que aborda el tema de la resiliencia en esquizofrenia. Los hallazgos de la presente revisión sitúan a la resiliencia como un factor determinante de la evolución y expresión clínica de esta enfermedad.

Introduction: resilience has been defined as the resistance to adverse psychosocial experiences. It has an important role in various mental disorders, being associated, for example, with the severity in major depressive disorder and the quality of life in bipolar affective disorder. Schizophrenia is a severe mental disorder that stands out for causing difficulties in multiple domains of life and high morbidity and mortality. The objective of this review was to synthesize the available evidence about the importance of resilience in schizophrenia. Methods: a search of the PubMed, LILACS and SciELO databases was performed, selecting articles in English and Spanish that included patients with schizophrenia and measured resilience. Twenty-five articles met the inclusion criteria. Results: patient with schizophrenia had less resilience than healthy subjects (9 studies). Resilience levels were inversely associated with negative symptoms (3 studies), positive symptoms (1 study), depression (4 studies), hopelessness (3 studies), and suicide (1 study). On the other hand, resilience was positively associated with quality of life (5 studies), functionality (4 studies) and physical health (2 studies). In two studies, interventions aimed at enhancing the resilience of patients with schizophrenia were evaluated, showing inconclusive results. Discussion: there is a striking limited literature that address the topic of resilience in schizophrenia. The findings of the present review place resilience as a determining factor in the evolution and clinical expression of this disease.

Recent Advances in the Discovery and Function of Antimicrobial Molecules in Platelets.

The conventional function described for platelets is maintaining vascular integrity. Nevertheless, increasing evidence reveals that platelets can additionally play a crucial role in responding against microorganisms. Activated platelets release molecules with antimicrobial activity. This ability was first demonstrated in rabbit serum after coagulation and later in rabbit platelets stimulated with thrombin. Currently, multiple discoveries have allowed the identification and characterization of PMPs (platelet microbicidal proteins) and opened the way to identify kinocidins and CHDPs (cationic host defense peptides) in human platelets. These molecules are endowed with microbicidal activity through different mechanisms that broaden the platelet participation in normal and pathologic conditions. Therefore, this review aims to integrate the currently described platelet molecules with antimicrobial properties by summarizing the pathways towards their identification, characterization, and functional evaluation that have promoted new avenues for studying platelets based on kinocidins and CHDPs secretion.

Características sociodemográficas, ambientales y clínicas en pacientes con cáncer gástrico en San Gil, Colombia / Sociodemographic, environmental and clinical characteristics in patients with gastric cancer in San Gil, Colombia

Introducción: en la actualidad, el cáncer gástrico sigue ocupando un lugar importante entre las causas de muerte a nivel mundial. Objetivo: determinar las características sociodemográficas, ambientales y clínicas de los pacientes con cáncer gástrico en el municipio de San Gil, Colombia. Metodología: estudio descriptivo transversal. La muestra estuvo conformada por 13 casos de personas con diagnóstico clínico e histopatológico de cáncer gástrico del municipio de San Gil, Santander, residentes del área rural y urbana. El análisis estadístico fue realizado con el programa Statistical Product and Service Solutions, versión 24.0 Resultados: el género con mayor afectación fue el masculino con un 62%. La mediana de edad de los participantes fue de 51 años con una edad mínima de 36 años y una edad máxima de 87 años. En el 61.5% el nivel de escolaridad fue la educación primaria. En cuanto a los factores ambientales, se encontró que el 69.2% consumieron alimentos salados y condimentados. Conclusiones: se encontró que una gran proporción de los participantes fueron del género masculino y residentes del casco urbano. Entre las ocupaciones, las más frecuentes fueron amas de casa y conductores de transporte pesado. Los síntomas que presentaron los participantes en el momento del diagnóstico fueron: pérdida de peso, hematemesis, dolor epigástrico y sensación de plenitud abdominal

Introduction: At present, gastric cancer continues to occupy an important place among the causes of death worldwide. Objective: To determine the sociodemographic, environmental, and clinical characteristics of patients with gastric cancer in the municipality of San Gil, Colombia. Methods: Descriptive cross-sectional study. The sample consisted of 13 cases of people with clinical and histopathological diagnosis of gastric cancer from the municipality of San Gil, Santander, who were residents of rural and urban areas. Statistical analysis was carried out with the program Statistical Product and Service Solutions (SPSS), version 24.0. Results: Men were the most affected, with 61.5%. The median age of the participants was 51 years with a minimum age of 36 years and a maximum of 87 years. In 61.5% the level of education was primary education. Regarding environmental factors, it was found that 69.2% consumed salty and spicy foods. Conclusions: It was found that a large proportion of the participants were male, urban residents. Concerning occupations, the most frequent were housewives and heavy truck drivers. Symptoms that participants presented at the time of diagnosis were weight loss, hematemesis, epigastric pain and fullness in upper abdomen.

[Negative effects of the patients' rights law and neuro-rights bill in Chile]. / Efectos negativos en la investigación y el quehacer médico en Chile de la Ley 20.584 y la Ley de Neuroderechos en discusión: la urgente necesidad de aprender de nuestros errores.

Recently, the Chilean Senate approved the main ideas of a constitutional reform and a Neuro-rights bill. This bill aims to protect people from the potential abusive use of "neuro-technologies". Unfortunately, a literal interpretation of this law can produce severe negative effects both in the development of neuroscience research and medical practice in Chile, interfering with current treatments in countless patients suffering from neuropsychiatric diseases. This fear stems from the observation of the negative effects that recent Chilean legislations have produced, which share with the Neuro-Rights Law the attempt to protect vulnerable populations from potential abuse from certain medical interventions. In fact, Law 20,584 promulgated in 2012, instead of protecting the most vulnerable patients "incapacitated to consent", produced enormous, and even possibly irreversible, damage to research in Chile in pathologies that require urgent attention, such as many neuropsychiatric diseases. This article details the effects that Law 20.584 had on research in Chile, how it relates to the Neuro-Rights Law, and the potential negative effects that the latter could have on research and medical practice, if it is not formulated correcting its errors.

Weighted neurofeedback facilitates greater self-regulation of functional connectivity between the primary motor area and cerebellum.

Objective.Brain-computer interface (BCI) is a tool that can be used to train brain self-regulation and influence specific activity patterns, including functional connectivity, through neurofeedback. The functional connectivity of the primary motor area (M1) and cerebellum play a critical role in motor recovery after a brain injury, such as stroke. The objective of this study was to determine the feasibility of achieving control of the functional connectivity between M1 and the cerebellum in healthy subjects. Additionally, we aimed to compare the brain self-regulation of two different feedback modalities and their effects on motor performance.Approach.Nine subjects were trained with a real-time functional magnetic resonance imaging BCI system. Two groups were conformed: equal feedback group (EFG), which received neurofeedback that weighted the contribution of both regions of interest (ROIs) equally, and weighted feedback group (WFG) that weighted each ROI differentially (30% cerebellum; 70% M1). The magnitude of the brain activity induced by self-regulation was evaluated with the blood-oxygen-level-dependent (BOLD) percent change (BPC). Functional connectivity was assessed using temporal correlations between the BOLD signal of both ROIs. A finger-tapping task was included to evaluate the effect of brain self-regulation on motor performance.Main results.A comparison between the feedback modalities showed that WFG achieved significantly higher BPC in M1 than EFG. The functional connectivity between ROIs during up-regulation in WFG was significantly higher than EFG. In general, both groups showed better tapping speed in the third session compared to the first. For WFG, there were significant correlations between functional connectivity and tapping speed.Significance.The results show that it is possible to train healthy individuals to control M1-cerebellum functional connectivity with rtfMRI-BCI. Besides, it is also possible to use a weighted feedback approach to facilitate a higher activity of one region over another.