The value of inquiring patients about local discomfort during blood pressure measurement for fibromyalgia detection. A cross-sectional study.

BACKGROUND: Fibromyalgia overlaps and/or mimics other rheumatic diseases and may be a confounding factor in the clinimetric assessment of these illnesses. Allodynia is a distinctive fibromyalgia feature that can be elicited during routine blood pressure measurement. For epidemiological purposes fibromyalgia can be diagnosed using the 2016 Wolfe et al. criteria questionnaire. No physical examination is required. OBJECTIVE: To evaluate the role of a straightforward question formulated during routine blood pressure measurement for fibromyalgia detection in a rheumatology outpatient clinic. PATIENTS AND METHODS: All adult patients attending our Rheumatology outpatient clinic were invited to participate. While awaiting their medical consultation, they filled-out the 2016 Wolfe et al. FM diagnostic criteria questionnaire. During the ensuing routine physical examination, the physician advanced the following guideline: "I am going to take your blood pressure; tell me if the cuff's pressure causes pain". Then, blood pressure cuff was inflated to 170 mm/Hg. Sphygmomanometry induced allodynia was defined as any local discomfort caused by blood pressure measurement. If a patient voiced any uneasiness, a follow-up dichotomic question was formulated "did it hurt much or little". Sphygmomanometry-induced allodynia was correlated with the presence of fibromyalgia according to the 2016 Wolfe diagnostic criteria. RESULTS: Four hundred and ninety-one patients were included in the study; most of them (84%) were female. The female cohort displayed the following features: Twenty five percent had fibromyalgia. Twenty seven percent had sphygmomanometry-induced allodynia. In women, sphygmomanometry-evoked allodynia had 63% sensitivity and 84% specificity for fibromyalgia diagnosis. The area under curve was 0.751. Moreover, having "much" local pain elicitation during blood pressure testing had 23% sensitivity and 96% specificity for fibromyalgia diagnosis. Men behaved differently; 15% fulfilled the fibromyalgia diagnostic criteria, but only 2% had sphygmomanometry induced allodynia. CONCLUSIONS: Inquiring female patients about local discomfort during routine blood pressure measurement is a simple and efficient procedure for fibromyalgia detection. This undemanding approach could be implemented in all clinical settings. There is marked sexual dimorphism in the link between sphygmomanometry-induced allodynia and fibromyalgia diagnosis. The presence of fibromyalgia is almost certain in those individuals having substantial pain elicitation during blood pressure measurement.

The subjective perception of the happiness of older adult residents in Colombia.

Introduction: Happiness is understood as the perception of subjective well-being, it can be a quality, a result, or a state characterized by well-being or satisfaction that every person wants to achieve. In older adults, this satisfaction is a sum of lifelong achievements and triumphs; However, some factors influence this ideal. Objective: Analyze demographic, family, social, personal, and health factors associated with the subjective perception of happiness in older adults, using data from a study conducted in five cities in Colombia, in order to make a theoretical contribution in the search for improvement of their physical, mental and social health. Materials and methods: A quantitative, cross-sectional, analytical study was carried out, using primary source information, obtained with 2,506 surveys from voluntary participants aged 60 and over, who had no cognitive impairment, and who reside in urban areas but not in long-term centers. The variable happiness (classified as high or moderate/low) was used for: (1) A univariate explorative characterization of older adult, (2) a bivariate estimation of the relationships with the factors studied, and (3) a multivariate construction of profiles through multiple correspondences. Results: 67.2% reported high happiness levels, with differences by city: Bucaramanga (81.6%), Pereira (74.7%), Santa Marta (67.4), Medellín (64%), and Pereira (48.7%). Happiness was explained by the absence of risk of depression and little hopelessness, strengthened psychological well-being, a perception of high quality of life, and living in a functional family. Conclusion: This study provided an overview of possible factors that can be enhanced and strengthened with public policies (structural determinant), community empowerment, family strengthening (intermediate determinant), and educational programs (proximal determinant). These aspects are included in the essential functions of public health, in favor of mental and social health in older adults.

Salmonella enterica Newserovar Abeokuta Genome Sequence, Strain OG19FER4 Isolated from Poultry Feed in Nigeria.

This report announces the genome of a newly confirmed Salmonella serovar (Salmonella enterica serovar Abeokuta) that was isolated from a poultry feed sample collected on a farm in Abeokuta, capital of Ogun State in Nigeria. Salmonella Abeokuta has not been identified outside Nigeria, nor does it appear to be a cause for concern for animal and human health.

Comparing Multiple Locus Variable-Number Tandem Repeat Analyses with Whole-Genome Sequencing as Typing Method for Salmonella Enteritidis Surveillance in The Netherlands, January 2019 to March 2020.

In the Netherlands, whole-genome sequencing (WGS) was implemented as routine typing tool for Salmonella Enteritidis isolates in 2019. Multiple locus variable-number tandem repeat analyses (MLVA) was performed in parallel. The objective was to determine the concordance of MLVA and WGS as typing methods for S. Enteritidis isolates. We included S. Enteritidis isolates from patients that were subtyped using MLVA and WGS-based core-genome Multilocus Sequence Typing (cgMLST) as part of the national laboratory surveillance of Salmonella during January 2019 to March 2020. The concordance of clustering based on MLVA and cgMLST, with a distance of ≤5 alleles, was assessed using the Fowlkes-Mallows (FM) index, and their discriminatory power using Simpson's diversity index. Of 439 isolates in total, 404 (92%) were typed as 32 clusters based on MLVA, with a median size of 4 isolates (range:2 to 141 isolates). Based on cgMLST, 313 (71%) isolates were typed as 48 clusters, with a median size of 3 isolates (range:2 to 39 isolates). The FM index was 0.34 on a scale from 0 to 1, where a higher value indicates greater similarity between the typing methods. The Simpson's diversity index of MLVA and cgMLST was 0.860 and 0.974, respectively. The median cgMLST distance between isolates with the same MLVA type was 27 alleles (interquartile range [IQR]:17 to 34 alleles), and 2 alleles within cgMLST clusters (IQR:1-5 alleles). This study shows the higher discriminatory power of WGS over MLVA and a poor concordance between both typing methods regarding clustering of S. Enteritidis isolates. IMPORTANCE Salmonella is the most frequently reported agent causing foodborne outbreaks and the second most common zoonoses in the European Union. The incidence of the most dominant serotype Enteritidis has increased in recent years. To differentiate between Salmonella isolates, traditional typing methods such as pulsed-field gel electrophoresis (PFGE) and multiple locus variable-number tandem repeat analyses (MLVA) are increasingly replaced with whole-genome sequencing (WGS). This study compared MLVA and WGS-based core-genome Multilocus Sequence Typing (cgMLST) as typing tools for S. Enteritidis isolates that were collected as part of the national Salmonella surveillance in the Netherlands. We found a higher discriminatory power of WGS-based cgMLST over MLVA, as well as a poor concordance between both typing methods regarding clustering of S. Enteritidis isolates. This is especially relevant for cluster delineation in outbreak investigations and confirmation of the outbreak source in trace-back investigations.

Fibrolipoma of the hard palate: an uncommon location. Case report / Fibrolipoma del paladar duro: una ubicación poco frecuente. Reporte de caso

Abstract Fibrolipoma, a benign soft tissue adipose tumor, is a histological variant of lipoma. Clinically, it presents as a painless slow-growing mass, indistinguishable from other benign soft tissue tumors. In the oral cavity, it is mainly encountered in the buccal mucosa. Involvement of the palate is very rare; it accounts for around 7-14% of all oral fibrolipomas. In this article, we describe a case of fibrolipoma in the hard palate of a 70-year-old female, who presented with an asymptomatic pedunculated mass, characterized by a normal-colored and smooth surface, which have been present for 20 years. The lesion was excised, and histopathological study revealed a fibrolipoma. To the best of our knowledge, only 17 cases occurring in the palate have been reported in the literature. Since fibrolipoma presents clinical similarities with other benign soft tissue neoplasms, a thorough clinical examination and histopathological analysis are essential for obtaining diagnosis.

Resumen El fibrolipoma es una neoplasia benigna de tejido adiposo, variante histológica del lipoma. Clínicamente se presenta como una tumoración de crecimiento lento, asintomática, indistinguible de otras neoplasias benignas de tejidos blandos. En cavidad oral se presenta principalmente en la mucosa yugal. El paladar es un sitio infrecuente, comprende del 7 al 14% de todos los fibrolipomas. En este reporte, describimos un caso de fibrolipoma de paladar duro en una mujer de 70 años de edad, que presentó una tumoración pediculada, asintomática, de superficie lisa, del mismo color de la mucosa adyacente, con un tiempo de evolución de 20 años. La lesión fue extirpada, y el estudio histopatológico reveló un fibrolipoma. En nuestro conocimiento, se han reportado en la literatura únicamente 17 casos de fibrolipoma de paladar. Siendo que el fibrolipoma presenta similitud clínica con otras neoplasias benignas de tejidos blandos, un examen clínico detallado, así como el estudio histopatológico son esenciales en la obtención del diagnóstico.

Pharmacological CDK4/6 inhibition reveals a p53-dependent senescent state with restricted toxicity.

Cellular senescence is a state of stable growth arrest and a desired outcome of tumor suppressive interventions. Treatment with many anti-cancer drugs can cause premature senescence of non-malignant cells. These therapy-induced senescent cells can have pro-tumorigenic and pro-disease functions via activation of an inflammatory secretory phenotype (SASP). Inhibitors of cyclin-dependent kinases 4/6 (CDK4/6i) have recently proven to restrain tumor growth by activating a senescence-like program in cancer cells. However, the physiological consequence of exposing the whole organism to pharmacological CDK4/6i remains poorly characterized. Here, we show that exposure to CDK4/6i induces non-malignant cells to enter a premature state of senescence dependent on p53. We observe in mice and breast cancer patients that the CDK4/6i-induced senescent program activates only a partial SASP enriched in p53 targets but lacking pro-inflammatory and NF-κB-driven components. We find that CDK4/6i-induced senescent cells do not acquire pro-tumorigenic and detrimental properties but retain the ability to promote paracrine senescence and undergo clearance. Our results demonstrate that SASP composition is exquisitely stress-dependent and a predictor for the biological functions of different senescence subsets.

C/EBPß isoform-specific regulation of migration and invasion in triple-negative breast cancer cells.

The transcription factor C/EBPß is a master regulator of mammary gland development and tissue remodelling during lactation. The CEBPB-mRNA is translated into three distinct protein isoforms named C/EBPß-LAP1, -LAP2 and -LIP that are functionally different. The smaller isoform LIP lacks the N-terminal transactivation domains and is considered to act as an inhibitor of the transactivating LAP1/2 isoforms by competitive binding for the same DNA recognition sequences. Aberrantly high expression of LIP is associated with mammary epithelial proliferation and is found in grade III, estrogen receptor (ER) and progesterone (PR) receptor-negative human breast cancer. Here, we show that reverting the high LIP/LAP ratios in triple-negative breast cancer (TNBC) cell lines into low LIP/LAP ratios by overexpression of LAP reduces migration and matrix invasion of these TNBC cells. In addition, in untransformed MCF10A human mammary epithelial cells overexpression of LIP stimulates migration. Knockout of CEBPB in TNBC cells where LIP expression prevails, resulted in strongly reduced migration that was accompanied by a downregulation of genes involved in cell migration, extracellular matrix production and cytoskeletal remodelling, many of which are epithelial to mesenchymal transition (EMT) marker genes. Together, this study suggests that the LIP/LAP ratio is involved in regulating breast cancer cell migration and invasion. This study together with studies from others shows that understanding the functions the C/EBPß-isoforms in breast cancer development may reveal new avenues of treatment.

Symptomatic, biochemical and radiographic recovery in patients with COVID-19.

BACKGROUND: The symptoms, radiography, biochemistry and healthcare utilisation of patients with COVID-19 following discharge from hospital have not been well described. METHODS: Retrospective analysis of 401 adult patients attending a clinic following an index hospital admission or emergency department attendance with COVID-19. Regression models were used to assess the association between characteristics and persistent abnormal chest radiographs or breathlessness. RESULTS: 75.1% of patients were symptomatic at a median of 53 days post discharge and 72 days after symptom onset and chest radiographs were abnormal in 47.4%. Symptoms and radiographic abnormalities were similar in PCR-positive and PCR-negative patients. Severity of COVID-19 was significantly associated with persistent radiographic abnormalities and breathlessness. 18.5% of patients had unscheduled healthcare visits in the 30 days post discharge. CONCLUSIONS: Patients with COVID-19 experience persistent symptoms and abnormal blood biomarkers with a gradual resolution of radiological abnormalities over time. These findings can inform patients and clinicians about expected recovery times and plan services for follow-up of patients with COVID-19.

Vulneración a la integridad física de personas mayores: prevalencia del maltrato y factores asociados / Violation of the Physical Integrity of the Elderly: Prevalence of Abuse and Related Factors

Resumen El envejecimiento poblacional que experimenta actualmente América Latina trae consigo retos para la sociedad, como la prevención de la vulneración a los derechos humanos y libertades de las personas mayores y la eliminación de todas las formas de maltrato. La prevalencia de maltrato físico a personas mayores fue de 4,1%. Se presentó principalmente en mujeres, personas sin pareja y con ingreso económico. Además, fue más prevalente en personas mayores con riesgo de depresión, ante cedentes de pensamientos suicidas, insatisfacción con la salud y que convivían con familias disfuncionales. Los hallazgos de esta investigación muestran como las re laciones familiares pueden ser un factor clave a la hora de abordar la problemática del maltrato; además, las graves repercusiones que generan estos hechos sobre la víctima, como afectaciones no solo a la salud física sino también mental.

Abstract The ageing population currently experienced by Latin America brings with it cha llenges for society, such as the prevention of human rights violation and freedoms of the elderly, and the elimination of all forms of abuse. The prevalence of physical abuse for the elderly was 4.1%. It was mainly presented in women, people without a partner, and with financial income. In addition, it was more prevalent in older people at risk of depression, a history of suicidal thoughts, dissatisfaction with health, and living with dysfunctional families. The findings of this research show how family re lationships can be a key factor in addressing the problem of abuse. In addition, the serious impact of these facts on the victim, such as affectations not only to physical health, but also to mental health.

Screening and characterization of medicinal plants extracts with bactericidal activity against Streptococcus mutans.

The aim of the present study was to perform a screening of extracts obtained from 15 medicinal plants using water (at 25 and 90 °C) or ethanol (at 25 °C), to bactericidal activity against cariogenic S. mutans ATCC 25175, as well as to carry out the preliminary phytochemical characterization of the extracts and HPLC/MS assay for selected extracts. The extractions were carried out for 5 h at 400 rpm. Only five from 45 tested extracts were selected based on their antibacterial activity. The IC50 varied from of 28 ppm for Quercus ilex up to 250 ppm for Jatropha dioica. Different polyphenolic and quinic acids, flavonoids, anthocyanin or tyrosol were identified by HPLC/MS in selected extracts from Rosa gallica L., Jatropha dioica Sessé, Mimosa tenuiflora (Willd.) Poir, Quercus ilex L., and Solanum nigrum. The obtained results confirm that selected extracts are good candidates to be used for cariogenic bacteria control.

¿Cúan segura es la dermatología quirúrgica?. Trabajo de investigación prospectivo sobre sus complicaciones realizado en una sala de procedimientos / How safe is dermatologic surgery? Prospective reserach work on complications in dermatologic surgery located in an office-based setting

Antecedentes: Aunque las complicaciones globales en la dermatología quirúrgica referidas en la bibliografía mundial son bajas (1,64- 4,58%), las publicaciones regionales con datos prospectivos sobre ellas son escasas y, a nivel nacional, inexistentes. Objetivos: Estimar la incidencia de complicaciones intraquirúrgicas (CI) y posquirúrgicas (CP) en los procedimientos de cirugía dermatológica y caracterizarlas en el ámbito de una sala de procedimientos de un hospital de referencia de la Ciudad Autónoma de Buenos Aires. Diseño: Trabajo de investigación descriptivo, prospectivo, observacional y longitudinal. Materiales y métodos: Se recolectó información demográfica del paciente y operativa en el momento del procedimiento quirúrgico. Se clasificaron las complicaciones quirúrgicas que se presentaron hasta un mes posterior al procedimiento en los pacientes intervenidos en la sección de Dermatología Quirúrgica del Hospital F. J. Muñiz, en el período comprendido entre febrero de 2015 y marzo de 2018. Resultados: Se halló una incidencia de 0% (IC 95%: 0 a 0,4) para las CI y de 4,4% (IC 95%: 3,2 a 5,9) para las CP en una serie de 765 pacientes (937 procedimientos). La CP más frecuente fue dehiscencia (68%), seguida de infección (16%), variantes de sangrado (9%) y necrosis (7%). Ninguna fue grave ni incluyó muerte, hospitalización o secuelas permanentes. Conclusiones: La dermatología quirúrgica en el ámbito de una sala de procedimientos es segura y el porcentaje de complicaciones es bajo comparable con lo publicado en la bibliografía internacional. (AU)

Background: Although the global complications in surgical dermatology referred to in the worldwide literature are low (1.64- 4.58%), regional publications with prospective data on them are scarce and nationally non-existent. Objectives: Estimate the incidence of intra-surgical complications (IC) and post-surgical complications (PC) in dermatological surgery procedures and characterize them within the scope of a reference hospital in the Autonomous City of Buenos Aires. Design: Descriptive, prospective, observational and longitudinal research work. Materials and methods: Demographic information of the patient and operative data were collected at the time of the surgical procedure. Surgical complications that occurred up to one month after the procedure on patients undergoing surgery in the surgical dermatology section of the F. J. Muñiz Hospital between February 2015 to March 2018 were classified. Results: The incidence found was 0% (95% CI 0-0.4) for IC and 4.4% (95% CI 3.2-5.9) for PC in a series of 765 patients (937 procedures). The most frequent PC was dehiscence (68%), followed by infection (16%), bleeding variants (9%) and necrosis (7%). Neither the PC were severe, not included death, hospitalization or permanent sequelae. Conclusions: Office based dermatologic surgery is safe and the percentage of complications is low, comparable to that published in the international literature. (AU)

Three (-)-cytisine derivatives and 1-hydroxyquinopimaric acid as acetylcholinesterase inhibitors.

In vitro acetylcholinesterase (AChE) inhibition was studied using novel derivatives of (-)-cytisine derivatives N-allylcytisine-12-carbamide (A-63), cytisine-12-carbamide (A-36), N-1-adamantylcytisine-12-thiocarbamide (U-12), and 1-hydroxyquinopimaric acid (U-201). Inhibition of acetylcholinesterase with compound A-63 was described as mixed inhibition. Substances (A-36) and (U-201) acted as competitive inhibitors with Ki equal to 6.71 mM and 3.89 mM, respectively, while (U-12) behaved as an uncompetitive inhibitor with Ki at 0.07 mM. The IC50 values were estimated at 1.47, 13.73, 3.39, and 7.81 mM, respectively. According to toxicity assessment, compound A-63 was non-toxic; it did not affect A. salina viability at a concentration less than 1000 ppm, while at 1000 ppm, only 3% mortality was observed. Mortality of A. salina was less than 50% in the same concentration range for the other three compounds that allow classifying them as moderately toxic. Although tested compounds have the characteristics of weak inhibitors, they could be useful as protectors against potent organophosphates. The present research may be fundamental to the design of new substances for acetylcholinesterase inhibition.

Identification of stable senescence-associated reference genes.

Cellular senescence is a state of permanent cell cycle arrest activated in response to damaging stimuli. Many hallmarks associated with senescent cells are measured by quantitative real-time PCR (qPCR). As the selection of stable reference genes for interpretation of qPCR data is often overlooked, we performed a systematic review to understand normalization strategies entailed in experiments involving senescent cells. We found that, in violation of the Minimum Information for publication of qPCR Experiments (MIQE) guidelines, most reports used only one reference gene to normalize qPCR data, and that stability of the reference genes was either not tested or not reported. To identify new and more stable reference genes in senescent fibroblasts, we analyzed the Shapiro-Wilk normality test and the coefficient of variation per gene using in public RNAseq datasets. We then compared the new reference gene candidates with commonly used ones by using both RNAseq and qPCR data. Finally, we defined the best reference genes to be used universally or in a strain-dependent manner. This study intends to raise awareness of the instability of classical reference genes in senescent cells and to serve as a first attempt to define guidelines for the selection of more reliable normalization methods.

Induction and Validation of Cellular Senescence in Primary Human Cells.

Cellular senescence is a state of permanent cell cycle arrest activated in response to different damaging stimuli. Activation of cellular senescence is a hallmark of various pathophysiological conditions including tumor suppression, tissue remodeling and aging. The inducers of cellular senescence in vivo are still poorly characterized. However, a number of stimuli can be used to promote cellular senescence ex vivo. Among them, most common senescence-inducers are replicative exhaustion, ionizing and non-ionizing radiation, genotoxic drugs, oxidative stress, and demethylating and acetylating agents. Here, we will provide detailed instructions on how to use these stimuli to induce fibroblasts into senescence. This protocol can easily be adapted for different types of primary cells and cell lines, including cancer cells. We also describe different methods for the validation of senescence induction. In particular, we focus on measuring the activity of the lysosomal enzyme Senescence-Associated ß-galactosidase (SA-ß-gal), the rate of DNA synthesis using 5-ethynyl-2'-deoxyuridine (EdU) incorporation assay, the levels of expression of the cell cycle inhibitors p16 and p21, and the expression and secretion of members of the Senescence-Associated Secretory Phenotype (SASP). Finally, we provide example results and discuss further applications of these protocols.

Index of vulnerability of elderly people in Medellín, Barranquilla, and Pasto

Introduction: Vulnerability can be defined as a lack of material and immaterial resources, which prevents the use of opportunities that may advance one's self-interest. The presence of these welfare resources prevents reductions in the quality of life. Objective: The objective of this study was to build an index of vulnerability using characteristics of the physical, human, social and functional capital of adults in three cities of Colombia in the year 2016 and to determine the factors that contribute most to vulnerability. Materials and methods: We conducted a transversal study with primary information sources applying 1,514 surveys among people aged 60 years and over in Medellín, Barranquilla, and Pasto. For the construction of the vulnerability index, we used factor analysis with varimax rotation and the principal component method. Results: The conditions that lead to a person's vulnerability were related mainly to human capital (quality of life, mental health and habits). The other types of capital that contributed to vulnerability were physical capital (occupation), social capital (accompaniment), and functional capital (functional independence). The highest vulnerability was registered among the residents of Pasto. The factors associated with vulnerability were the city of residence, the sex, the educational level and the role of the person in the home. Conclusion: In 58.55% of elderly people vulnerability was explained by the use of time, the functional independence and the subjective well-being. These findings contribute to the improvement of the quality of life, mainly those related to maintaining functional independence as long as possible, being occupied, improving mental health, and avoiding the risks of depression, anxiety, cognitive deterioration and deleterious habits.

Índice de vulnerabilidad de adultos mayores en Medellín, Barranquilla y Pasto / Index of vulnerability of elderly people in Medellín, Barranquilla, and Pasto

Resumen Introducción. La vulnerabilidad puede entenderse como la carencia de recursos materiales e inmateriales que impide el aprovechamiento de oportunidades en distintos aspectos de la vida. Estos recursos de bienestar evitan el deterioro de la calidad de vida. Objetivo. Construir un índice de vulnerabilidad con las características de los capitales físico, humano, social y funcional de los adultos mayores de tres ciudades de Colombia en el 2016, y determinar los factores asociados con esta condición. Materiales y métodos. Se hizo un estudio transversal con información primaria mediante 1.514 encuestas a personas de 60 años omásde Medellín, Barranquilla y Pasto. En la construcción del índice se usó el análisis factorial con losmétodos de componentes principales y de rotación ortogonal varimax. Resultados. Las condiciones que generaban vulnerabilidad se relacionaron principalmente con el capital humano (calidad de vida, salud mental y hábitos); los demás capitales aportaron un solo componente, así: capital físico (ocupación), capital social (acompañamiento) y capital funcional (independencia funcional). La vulnerabilidad fue mayor en los residentes de Pasto. Los factores asociados con la vulnerabilidad fueron la ciudad de residencia, el sexo, el nivel educativo y el rol en el hogar. Conclusión. En el 58,55 % de las personas mayores, la vulnerabilidad se explicó por el uso del tiempo, la independencia funcional y el bienestar subjetivo. Estos hallazgos aportan elementos para el mejoramiento de la calidad de vida, principalmente en cuanto a la capacidad funcional para mantener la independencia, estar ocupados y fortalecer la salud mental.

Abstract Introduction: Vulnerability can be defined as a lack of material and immaterial resources, which prevents the use of opportunities that may advance one's self-interest. The presence of these welfare resources prevents reductions in the quality of life. Objective: The objective of this study was to build an index of vulnerability using characteristics of the physical, human, social and functional capital of adults in three cities of Colombia in the year 2016 and to determine the factors that contribute most to vulnerability. Materials and methods: We conducted a transversal study with primary information sources applying 1,514 surveys among people aged 60 years and over in Medellín, Barranquilla, and Pasto. For the construction of the vulnerability index, we used factor analysis with varimax rotation and the principal component method. Results: The conditions that lead to a person's vulnerability were related mainly to human capital (quality of life, mental health and habits). The other types of capital that contributed to vulnerability were physical capital (occupation), social capital (accompaniment), and functional capital (functional independence). The highest vulnerability was registered among the residents of Pasto. The factors associated with vulnerability were the city of residence, the sex, the educational level and the role of the person in the home. Conclusion: In 58.55% of elderly people vulnerability was explained by the use of time, the functional independence and the subjective well-being. These findings contribute to the improvement of the quality of life, mainly those related to maintaining functional independence as long as possible, being occupied, improving mental health, and avoiding the risks of depression, anxiety, cognitive deterioration and deleterious habits.

Hallmarks of Cellular Senescence.

Cellular senescence is a permanent state of cell cycle arrest that promotes tissue remodeling during development and after injury, but can also contribute to the decline of the regenerative potential and function of tissues, to inflammation, and to tumorigenesis in aged organisms. Therefore, the identification, characterization, and pharmacological elimination of senescent cells have gained attention in the field of aging research. However, the nonspecificity of current senescence markers and the existence of different senescence programs strongly limit these tasks. Here, we describe the molecular regulators of senescence phenotypes and how they are used for identifying senescent cells in vitro and in vivo. We also highlight the importance that these levels of regulations have in the development of therapeutic targets.

Unmasking Transcriptional Heterogeneity in Senescent Cells.

Cellular senescence is a state of irreversibly arrested proliferation, often induced by genotoxic stress [1]. Senescent cells participate in a variety of physiological and pathological conditions, including tumor suppression [2], embryonic development [3, 4], tissue repair [5-8], and organismal aging [9]. The senescence program is variably characterized by several non-exclusive markers, including constitutive DNA damage response (DDR) signaling, senescence-associated ß-galactosidase (SA-ßgal) activity, increased expression of the cyclin-dependent kinase (CDK) inhibitors p16INK4A (CDKN2A) and p21CIP1 (CDKN1A), increased secretion of many bio-active factors (the senescence-associated secretory phenotype, or SASP), and reduced expression of the nuclear lamina protein LaminB1 (LMNB1) [1]. Many senescence-associated markers result from altered transcription, but the senescent phenotype is variable, and methods for clearly identifying senescent cells are lacking [10]. Here, we characterize the heterogeneity of the senescence program using numerous whole-transcriptome datasets generated by us or publicly available. We identify transcriptome signatures associated with specific senescence-inducing stresses or senescent cell types and identify and validate genes that are commonly differentially regulated. We also show that the senescent phenotype is dynamic, changing at varying intervals after senescence induction. Identifying novel transcriptome signatures to detect any type of senescent cell or to discriminate among diverse senescence programs is an attractive strategy for determining the diverse biological roles of senescent cells and developing specific drug targets.

[Contextual effects associated with depression risk variability in the elderly, Antioquia, Colombia, 2012]. / Efectos contextuales asociados a la variabilidad del riesgo de depresión en adultos mayores, Antioquia, Colombia, 2012.

INTRODUCTION: Depression is an affective disorder where interest in living is lost and functional areas like work, feelings, personal life, and relationships are negatively altered. However, little has been said about the association between place of residence and this mood disorder. OBJECTIVE: To determine the effects of the municipality and block of residence on the depression risk variability in the elderly in the Department of Antioquia, Colombia, in 2012. MATERIALS AND METHODS: This was a multilevel descriptive study of secondary source records of 4,060 elderly people from the Department of Antioquia. Demographic, social and functional characteristics were assessed to calculate raw and adjusted odds ratios and find an association between the risk of depression, as measured by Yesavage´s Geriatric Depression Scale, and context variables (municipality and block of residence) in the design of the model. We used Markov chain Monte Carlo estimation methods and the deviance information criterion to assess goodness of fit. RESULTS: The prevalence of the risk of depression was 29.5% and we found an association with ages over 75 years, being female, residing in rural areas, and widowhood. Additionally, they had a higher risk of anxiety, moderate functional capacity and malnutrition. The municipality and block of residence were associated with this risk in the elderly. CONCLUSIONS: The municipality and block of residence had a 10% contribution toward the total variability in the risk of depression for the elderly. This information is important to encourage participation and adherence of the elderly to community groups.

Efectos contextuales asociados a la variabilidad del riesgo de depresión en adultos mayores, Antioquia, Colombia, 2012 / Contextual effects associated with depression risk variability in the elderly, Antioquia, Colombia, 2012

Introducción. La depresión es un trastorno del afecto en el que se pierde el interés de vivir y se alteran de manera negativa los ámbitos laboral, afectivo, relacional y personal. Sin embargo, poco se sabe sobre si hay asociación entre el lugar de residencia y dicha alteración del estado de ánimo. Objetivo. Determinar los efectos del municipio y la manzana de residencia en la variabilidad del riesgo de depresión en los adultos mayores del departamento de Antioquia, Colombia, en el 2012. Materiales y métodos. Se llevó a cabo un estudio descriptivo multinivel de fuente secundaria con 4.060 registros de adultos mayores del departamento de Antioquia. Se valoraron características demográficas, sociales y funcionales en el cálculo de las razones de momios ( odds ratio, OR) crudas y ajustadas, para buscar asociación entre el riesgo de depresión medida con la escala de depresión geriátrica de Yesavage y las variables de contexto (municipio y manzana de residencia) en la construcción del modelo, utilizando los métodos de cadenas de Markov Monte Carlo ( Markov Chain Monte Carlo , MCMC); la bondad de ajuste de los modelos se evaluó mediante el criterio de información de la desviación ( Deviance Information Criterion , DIC). Resultados. La prevalencia del riesgo de depresión fue de 29,5 % y se encontró asociación con la edad mayor de 75 años, el sexo femenino, la residencia en zona rural y la condición de viudez. De igual forma, se encontró riesgo de experimentar ansiedad, capacidad funcional moderada y alto riesgo de desnutrición. Se encontró asociación entre el municipio y la manzana de residencia, y el riesgo de depresión. Conclusiones. El municipio y la manzana de residencia aportaron 10 % de la variabilidad total del riesgo de depresión en los adultos mayores. Esta información es importante para fomentar la participación y adhesión de los adultos mayores a grupos comunitarios.

Introduction: Depression is an affective disorder where interest in living is lost and functional areas like work, feelings, personal life, and relationships are negatively altered. However, little has been said about the association between place of residence and this mood disorder. Objective: To determine the effects of the municipality and block of residence on the depression risk variability in the elderly in the Department of Antioquia, Colombia, in 2012. Materials and methods: This was a multilevel descriptive study of secondary source records of 4,060 elderly people from the Department of Antioquia. Demographic, social and functional characteristics were assessed to calculate raw and adjusted odds ratios and find an association between the risk of depression, as measured by Yesavage´s Geriatric Depression Scale, and context variables (municipality and block of residence) in the design of the model. We used Markov chain Monte Carlo estimation methods and the deviance information criterion to assess goodness of fit. Results: The prevalence of the risk of depression was 29.5% and we found an association with ages over 75 years, being female, residing in rural areas, and widowhood. Additionally, they had a higher risk of anxiety, moderate functional capacity and malnutrition. The municipality and block of residence were associated with this risk in the elderly. Conclusions: The municipality and block of residence had a 10% contribution toward the total variability in the risk of depression for the elderly. This information is important to encourage participation and adherence of the elderly to community groups.