Role of the Solvent and Intramolecular Hydrogen Bonds in the Antioxidative Mechanism of Prenylisoflavone from Leaves of Vatairea guianensis.

This work discusses the electron structure, antioxidative properties, and solvent contribution of two new antioxidant molecules discovered, named S10 and S11, extracted from a medicinal plant called Vatairea guianensis, found in the Amazon rain-forest. To gain a better understanding, a study using density functional theory coupled with the polarizable-continuum model and the standard 6-311++G(d,p) basis set was conducted. The results indicate that S10 has a higher antioxidant potential than S11, confirming the experimental expectations. In the gas phase, the hydrogen atom transfer route dominates the hydrogen scavenging procedure. However, in the water solvents, the antioxidant mechanism prefers the sequential proton loss electron transfer mechanism. Furthermore, the solvent plays a fundamental role in the antioxidant mechanism. The formation of an intramolecular OH···OCH3 hydrogen bond is crucial for accurately describing the hydrogen scavenging phenomenon, better aligning with the experimental data. The results suggest that the two isoflavones investigated are promising for the pharmacologic and food industries.

pyBrick-DNA: A Python-Based Environment for Automated Genetic Component Assembly.

Genetic component assembly is key in the simulation and implementation of genetic circuits. Automating this process, thus accelerating prototyping, is a necessity. We present pyBrick-DNA, a software written in Python, that assembles components for the construction of genetic circuits. pyBrick-DNA (colab.pyBrick.com) is a user-friendly environment where scientists can select genetic sequences or input custom sequences to build genetic assemblies. All components are modularly fused to generate a ready-to-go single DNA fragment. It includes Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) and plant gene-editing components. Hence, pyBrick-DNA can generate a functional CRISPR construct composed of a single-guided RNA integrated with Cas9, promoters, and terminator elements. The outcome is a DNA sequence, along with a graphical representation, composed of user-selected genetic parts, ready to be synthesized and cloned in vivo. Moreover, the sequence can be exported as a GenBank file allowing its use with other synthetic biology tools.

Peritoneal Dialysis during the COVID-19 Pandemic Is an Effective Treatment in Developing Countries: A Report from Mexico.

INTRODUCTION: During the height of the coronavirus disease-19 (COVID-19) pandemic, some renal replacement therapy (RRT) modalities were insufficient, forcing medical centers to diversify the RRT modalities offered. In this study, we reported the outcomes of chronic peritoneal dialysis (PD) patients and acute PD in critically ill patients during COVID-19 pandemic in a tertiary care medical center in Mexico. METHODS: This descriptive, longitudinal, observational, retrospective study included 47 adult patients with atypical pneumonia in a tertiary care medical center in Mexico during the first and second waves of the COVID-19 pandemic. Chronic PD patients and PD incident patients due to acute kidney injury (AKI) were included. RESULTS: Forty-seven patients were studied (29 chronic PD patients and 18 incident PD patients due to AKI); median age was 59 (48-68) years; 63.8% were men. The ultrafiltrate volume per day was 815 (596.1-1,193.2) mL. Overall mortality was 61.7%, 55.2% in chronic PD patients, and 72.2% in PD incident patients due to AKI. A higher Sequential Organ Failure Assessment (SOFA) score, the need for mechanical ventilation at admission, and the requirement for vasopressors were predictors for mortality (p < 0.01). CONCLUSION: In low- and lower-middle-income countries, PD was a valid alternative for RRT during the COVID-19 pandemic. In AKI patients, PD can correct hyperkalemia, acidosis, uremia, and volume overload; however, there was higher mortality in PD incident patients due to AKI. The main risk factors for mortality were a high SOFA score at admission, the need for invasive mechanical ventilation, and the requirement for vasopressors.

[Autoimmune/inflammatory syndrome induced by adjuvants. Case report]. / Síndrome autoinmunitario/inflamatorio inducido por adyuvantes. Reporte de caso.

Background: The indiscriminate application of substances for aesthetic purposes, such as silicone in breast implants, leads to the production of common local signs such as inflammation, skin irregularities, edema, erythema, vascular neoformations, and ulcers, which can evolve into general symptoms such as fever, asthenia, weakness, arthralgia or activate the immune system abnormally, causing the appearance of autoimmune diseases. This set of signs and symptoms is called adjuvant-induced autoimmune/inflammatory syndrome. Clinical case: We present the case of a 50-year-old woman with a history of silicone-based breast implants who spontaneously developed a hemorrhagic coagulopathy, type A acquired hemophilia was documented, that is, autoantibodies against coagulation factor VIII. Thanks to the work of a multidisciplinary team, it is possible to successfully diagnose and treat the patient with bridging agents, implant removal and management of associated symptoms. Conclusion: the importance of knowing the pathology is recognized, which, although it is rare, when it occurs has a high mortality rate if it is not diagnosed and treated on time.

Introducción: la aplicación de sustancias con fines estéticos de forma indiscriminada, como es el caso de la silicona en los implantes mamarios, llevan a la producción de signos locales comunes como: inflamación, irregularidad en la piel, edema, eritema, neoformaciones vasculares y úlceras, que pueden evolucionar a síntomas generales como la fiebre, astenia, adinamia, artralgias o a activar, de manera anómala, el sistema inmunitario, causando la aparición de enfermedades autoinmunitarias. A este conjunto de signos y síntomas se le denomina síndrome autoinmunitario/inflamatorio inducido por adyuvantes. Caso clínico: presentamos el caso de una mujer de 50 años con antecedente de implantes mamarios a base de silicona que desarrolla, de manera espontánea, una coagulopatía hemorrágica, se documenta hemofilia tipo A adquirida, es decir, autoanticuerpos contra el factor VIII de la coagulación. Gracias al trabajo de un equipo multidisciplinario se consigue diagnosticar y tratar de manera exitosa a la paciente con agentes de puente, remoción de los implantes y manejo de los síntomas asociados. Conclusión: se reconoce la importancia de conocer la patología que, si bien es rara, cuando se presenta tiene alta tasa de mortalidad si no se diagnostica y trata a tiempo.

Size and Quality of Quantum Mechanical Data Set for Training Neural Network Force Fields for Liquid Water.

Molecular dynamics simulations have been used in different scientific fields to investigate a broad range of physical systems. However, the accuracy of calculation is based on the model considered to describe the atomic interactions. In particular, ab initio molecular dynamics (AIMD) has the accuracy of density functional theory (DFT) and thus is limited to small systems and a relatively short simulation time. In this scenario, Neural Network Force Fields (NNFFs) have an important role, since they provide a way to circumvent these caveats. In this work, we investigate NNFFs designed at the level of DFT to describe liquid water, focusing on the size and quality of the training data set considered. We show that structural properties are less dependent on the size of the training data set compared to dynamical ones (such as the diffusion coefficient), and a good sampling (selecting data reference for the training process) can lead to a small sample with good precision.

Tricuspid Valve-in-Valve Procedure with An Edwards S3 Valve in a 15-kg Child in Latin America

ABSTRACT A 5-year-old child, weighing 15 kg, with three previous sternotomies, presented with right heart failure due to severe stenosis and regurgitation of the bioprosthetic tricuspid valve. A percutaneous tricuspid valve-in-valve procedure with an Edwards S3 valve was ofered for compassionate use, performed with no complications and with a significant clinical condition improvement.

Tricuspid Valve-in-Valve Procedure with An Edwards S3 Valve in a 15-kg Child in Latin America.

A 5-year-old child, weighing 15 kg, with three previous sternotomies, presented with right heart failure due to severe stenosis and regurgitation of the bioprosthetic tricuspid valve. A percutaneous tricuspid valve-in-valve procedure with an Edwards S3 valve was ofered for compassionate use, performed with no complications and with a significant clinical condition improvement.

Quantitative Proteomic Analysis of Cervical Cancer Tissues Identifies Proteins Associated With Cancer Progression.

BACKGROUND/AIM: To date, several proteomics studies in cervical cancer (CC) have focused mainly on squamous cervical cancer (SCC). Our study aimed to discover and clarify differences in SCC and CAD that may provide valuable information for the identification of proteins involved in tumor progression, in CC as a whole, or specific for SCC or CAD. MATERIALS AND METHODS: Total protein extracts from 15 individual samples corresponding to 5 different CC tissue types were compared with a non-cancerous control group using bidimensional liquid chromatography-mass spectrometry (2D LC-MS/MS), isobaric tags for relative and absolute quantitation (ITRAQ), principal component analysis (PCA) and gene set enrichment analysis (GSEA). RESULTS: A total of 622 statistically significant different proteins were detected. Exocytosis-related proteins were the most over-represented, accounting for 25% of the identified and quantified proteins. Based on the experimental results, reticulocalbin 3 (RCN3) and Ras-related protein Rab-14 (RAB14) were chosen for further downstream in vitro and vivo analyses. RCN3 was overexpressed in all CC tissues compared to the control and RAB14 was overexpressed in squamous cervical cancer (SCC) compared to invasive cervical adenocarcinoma (CAD). In the tumor xenograft experiment, RAB14 protein expression was positively correlated with increased tumor size. In addition, RCN3-expressing HeLa cells induced a discrete size increment compared to control, at day 47 after inoculation. CONCLUSION: RAB14 and RCN3 are suggested as potential biomarkers and therapeutic targets in the treatment of CC.

Spatiotemporal Surveillance of SARS-CoV-2 in the Sewage of Three Major Urban Areas in Peru: Generating Valuable Data Where Clinical Testing Is Extremely Limited.

Peru has been severely affected by the COVID-19 pandemic. By January 2022, Peru had surpassed 200 000 COVID-19 deaths, constituting the highest death rate per capita worldwide. Peru has had several limitations during the pandemic: insufficient testing access, limited contact tracing, a strained medical infrastructure, and many economic hurdles. These limitations hindered the gathering of accurate information about infected individuals with spatial resolution in real time, a critical aspect of effectively controlling the pandemic. Wastewater monitoring for SARS-CoV-2 RNA offered a promising alternative for providing needed population-wide information to complement health care indicators. In this study, we demonstrate the feasibility and value of implementing a decentralized SARS-CoV-2 RNA wastewater monitoring system to assess the spatiotemporal distribution of COVID-19 in three major cities in Peru: Lima, Callao, and Arequipa. Our data on viral loads showed the same trends as health indicators such as incidence and mortality. Furthermore, we were able to identify hot spots of contagion within the surveyed urban areas to guide the efforts of health authorities. Viral decay in the sewage network of the cities studied was found to be negligible (<2%). Overall, our results support wastewater monitoring for SARS-CoV-2 as a valuable and cost-effective tool for monitoring the COVID-19 pandemic in the Peruvian context.

Access to paediatric cardiac surgery in Colombia: a population-based study.

OBJECTIVES: Globally congenital heart disease mortality is declining, yet the proportion of infant deaths attributable to heart disease rises in Colombia and other middle-sociodemographic countries. We aimed to assess the accessibility of paediatric cardiac surgery (PCS) to children <18 years of age in 2016 in the South American country of Colombia. METHODS: In Bogotá, Colombia, a multi-national team used cross-sectional and retrospective cohort study designs to adapt and evaluate 4 health system indicators at the national level: first, the population with timely geographic access to an institution providing PCS; second, the number of paediatric cardiac surgeons; third, this specialized procedure volume and its national distribution; and fourth, the 30-day perioperative mortality rate after PCS in Colombia. RESULTS: Geospatial mapping approximates 64% (n = 9 894 356) of the under-18 Colombian population lives within 2-h drivetime of an institution providing PCS. Twenty-eight cardiovascular surgeons report performing PCS, 82% (n = 23) with formal training. In 2016, 1281 PCS procedures were registered, 90% of whom were performed in 6 of the country's 32 departments. National non-risk-adjusted all-cause 30-day perioperative mortality rate after PCS was 2.73% (n = 35). CONCLUSIONS: Colombia's paediatric population had variable access to cardiac surgery in 2016, largely dependent upon geography. While the country may have the capacity to provide timely, high-quality care to those who need it, our study enables future comparative analyses to measure the impact of health system interventions facilitating healthcare equity for the underserved populations across Colombia and the Latin American region.

Leptin and its receptor are overexpressed in breast cancer tissue of postmenopausal Mexican-Mestizo women with obesity.

The aim of this study was to investigate the expression of leptin (LEP) and its receptor (LEPR) in breast cancer tissue of postmenopausal women with different body mass indexes (BMI), as well as the relationship of this expression with the rate of recurrence free survival (RFS). Leptin and LEPR expression, determined by immunohistochemistry, were studied in breast cancer tissues of 154 patients. Qualitative and semi-quantitative analysis of protein expression was performed by the H-Score method, through the ImageJ's IHC Profiler software. Kaplan-Meier survival analysis and log-rank statistic were used to estimate RFS differences. Protein expression of LEP, was significantly higher in women with overweight or with obesity, when compared to women with normal BMI (P = 0.032 and P = 0.013, respectively). We also observed a significantly higher expression of LEPR in breast tumor cells of women with obesity (58.8%), when compared to women with normal BMI (32.7%) (P = 0.007). Five-year survival rate, regarding LEPR expression, was 82.4% when positive and 94% when negative (P = 0.024). In the Cox proportional-hazards regression model, LEPR expression represented a risk factor for disease recurrence after adjustment for confounding factors (HR = 4.67; 95% CI: 1.13-19.31; P = 0.033). In conclusion, postmenopausal women with obesity and breast cancer present higher LEP and LEPR expression in breast tumors, when compared to women with normal BMI. Independently from BMI, women with tumors LEPR positive have worst RFS, when compared to women with tumors LEPR negative.

Anemia ferropénica en lactantes ingresados en un servicio de Pediatría / Iron deficiency anemia in infants admitted to a Pediatric service

Fundamento: la anemia se define como una reducción de la concentración de hemoglobina por debajo de los valores registrados en las personas sanas. En Cuba, al igual que en el resto del mundo, la anemia ferropénica constituye un problema de salud, con elevada frecuencia en pacientes pediátricos. Objetivo: identificar dentro de un conjunto de factores de riesgo biológicos, cuáles tienen mayor asociación a la anemia ferropénica en lactantes hospitalizados en sala de pediatría del Hospital Luis Díaz Soto. Métodos: estudio descriptivo, de corte transversal. El universo estuvo conformado por 384 lactantes y la muestra la constituyeron 105 pacientes. Se realizó un muestreo aleatorio simple. Para identificar dentro de un grupo de factores de riesgo biológico sobre la aparición de anemia ferropénica, se realizó análisis univariado mediante la prueba de independencia X2. Se calculó el OR para aquellas variables que según prueba de X2 se mostraron estadísticamente significativas. Resultados: se constató prevalencia de anemia ferropénica en lactantes ingresados en más de la mitad de la muestra estudiada (61 porciento). Se determinó que la lactancia materna exclusiva por menos de seis meses (OR: 2,1; IC: 1,9-2,5) y la alimentación complementaria (OR: 1,5; IC: 1,3-2,4) constituyen factores de riesgo en el lactante ingresado para la aparición de anemia ferropénica. Conclusiones: la prevalencia de anemia ferropénica en lactantes ingresados en sala de pediatría del Hospital Luis Díaz Soto en el periodo de mayo a 2019 a mayo de 2020, fue alta y se comportó entre los valores esperados en lactantes hospitalizados (AU)

Background: anemia is defined as a reduction in hemoglobin concentration below the values recorded in healthy persons. In Cuba, as in the rest of the world, iron deficiency anemia is a health problem, with a high frequency in pediatric patients. Objective: to identify within a group of biological risk factors, which ones have a greater association with iron deficiency anemia in infants hospitalized in the pediatric ward of the Luis Díaz Soto Hospital. Methods: a descriptive, cross-sectional study was carried out. The universe was made up of 384 infants and the sample was made up of 105 patients. A simple random sampling was made. In order to identify within a group of biological risk factors on the appearance of iron-deficiency anemia, unvaried analysis was carried out by means of the X2 independence test. The OR was calculated for those variables which, according to the X2 test, were statistically significant. Results: prevalence of iron-deficiency anemia was found in infants admitted in more than half of the studied sample (61 percent). It was determined that exclusive breastfeeding for less than six months (OR: 2,1; IC: 1,9-2,5) and complementary feeding (OR: 1,5; IC: 1,3-2,4) were risk factors for iron-deficiency anemia in the infant admitted. Conclusions: the prevalence of iron-deficiency anemia in infants admitted to the pediatric ward of the Luis Díaz Soto Hospital during the period May 2019 to May 2020 is high and is among the expected values in hospitalized infants (AU)

Anemia ferropénica en lactantes ingresados en un servicio de Pediatría / Iron deficiency anemia in infants admitted to a Pediatric service

RESUMEN Fundamento: la anemia se define como una reducción de la concentración de hemoglobina por debajo de los valores registrados en las personas sanas. En Cuba, al igual que en el resto del mundo, la anemia ferropénica constituye un problema de salud, con elevada frecuencia en pacientes pediátricos. Objetivo: identificar dentro de un conjunto de factores de riesgo biológicos, cuáles tienen mayor asociación a la anemia ferropénica en lactantes hospitalizados en sala de pediatría del Hospital Luis Díaz Soto. Métodos: estudio descriptivo, de corte transversal. El universo estuvo conformado por 384 lactantes y la muestra la constituyeron 105 pacientes. Se realizó un muestreo aleatorio simple. Para identificar dentro de un grupo de factores de riesgo biológico sobre la aparición de anemia ferropénica, se realizó análisis univariado mediante la prueba de independencia X2. Se calculó el OR para aquellas variables que según prueba de X2 se mostraron estadísticamente significativas. Resultados: se constató prevalencia de anemia ferropénica en lactantes ingresados en más de la mitad de la muestra estudiada (61 %). Se determinó que la lactancia materna exclusiva por menos de seis meses (OR: 2,1; IC: 1,9-2,5) y la alimentación complementaria (OR: 1,5; IC: 1,3-2,4) constituyen factores de riesgo en el lactante ingresado para la aparición de anemia ferropénica. Conclusiones: la prevalencia de anemia ferropénica en lactantes ingresados en sala de pediatría del Hospital Luis Díaz Soto en el periodo de mayo a 2019 a mayo de 2020, fue alta y se comportó entre los valores esperados en lactantes hospitalizados.

ABSTRACT Background: anemia is defined as a reduction in hemoglobin concentration below the values recorded in healthy persons. In Cuba, as in the rest of the world, iron deficiency anemia is a health problem, with a high frequency in pediatric patients. Objective: to identify within a group of biological risk factors, which ones have a greater association with iron deficiency anemia in infants hospitalized in the pediatric ward of the Luis Díaz Soto Hospital. Methods: a descriptive, cross-sectional study was carried out. The universe was made up of 384 infants and the sample was made up of 105 patients. A simple random sampling was made. In order to identify within a group of biological risk factors on the appearance of iron-deficiency anemia, unvaried analysis was carried out by means of the X2 independence test. The OR was calculated for those variables which, according to the X2 test, were statistically significant. Results: prevalence of iron-deficiency anemia was found in infants admitted in more than half of the studied sample (61 %). It was determined that exclusive breastfeeding for less than six months (OR: 2,1; IC: 1,9-2,5) and complementary feeding (OR: 1,5; IC: 1,3-2,4) were risk factors for iron-deficiency anemia in the infant admitted. Conclusions: the prevalence of iron-deficiency anemia in infants admitted to the pediatric ward of the Luis Díaz Soto Hospital during the period May 2019 to May 2020 is high and is among the expected values in hospitalized infants.

Using Neural Network Force Fields to Ascertain the Quality of Ab Initio Simulations of Liquid Water.

Accurately simulating the properties of bulk water, despite the apparent simplicity of the molecule, is still a challenge. In order to fully understand and reproduce its complex phase diagram, it is necessary to perform simulations at the ab initio level, including quantum mechanical effects both for electrons and nuclei. This comes at a high computational cost, given that the structural and dynamical properties tend to require long timescales and large simulation cells. In this work, we evaluate the errors that density functional theory (DFT)-based simulations routinely incur into due time- and size-scale limitations. These errors are evaluated using neural-network-trained force fields that are accurate at the level of DFT methods. We compare different exchange and correlation potentials for properties of bulk water that require large timescales. We show that structural properties are less dependent on the system size and that dynamical properties such as the diffusion coefficient have a strong dependence on the simulation size and timescale. Our results facilitate comparisons of DFT-based simulation results with experiments and offer a path to discriminate between model and convergence errors in these simulations.

Comprehensive omic characterization of breast cancer in Mexican-Hispanic women.

Breast cancer is a heterogeneous pathology, but the genomic basis of its variability remains poorly understood in populations other than Caucasians. Here, through DNA and RNA portraits we explored the molecular features of breast cancers in a set of Hispanic-Mexican (HM) women and compared them to public multi-ancestry datasets. HM patients present an earlier onset of the disease, particularly in aggressive clinical subtypes, compared to non-Hispanic women. The age-related COSMIC signature 1 was more frequent in HM women than in those from other ancestries. We found the AKT1E17K hotspot mutation in 8% of the HM women and identify the AKT1/PIK3CA axis as a potentially druggable target. Also, HM luminal breast tumors present an enhanced immunogenic phenotype compared to Asiatic and Caucasian tumors. This study is an initial effort to include patients from Hispanic populations in the research of breast cancer etiology and biology to further understand breast cancer disparities.

Creation of Formalin-Fixed, Paraffin-Embedded 3D Lung Cancer Cellular Spheroids for the Optimization of Immunohistochemistry Staining Procedures.

In an era of precision medicine important treatment decisions are dictated by expression of clinically informative tumor protein biomarkers. These biomarkers can be detected by immunohistochemistry (IHC) performed in tumor tissue sections obtained from biopsies or resections. Like all experimental procedures, IHC needs optimization for several of its steps. However, the investigator must avoid optimizing the IHC procedure using valuable human biopsy samples which may be difficult to obtain. Ideally, valuable biopsy samples should only be subjected to IHC once the IHC protocol has been optimized. In this chapter, we describe a procedure for IHC optimization using tri-dimensional (3D) cellular spheroids created from cultured cells. In this approach, cultured cells are pelleted into 3D spheroids, which are then processed just like a tissue sample, namely, fixed, embedded, sectioned, mounted on slides, and stained with IHC just like a human tissue sample. These 3D cellular spheroids have a tissue-like architecture and cellularity resembling a tumor section, and both cellular and antigen structure are preserved. This method is therefore acceptable for IHC optimization before proceeding to the IHC staining of human tumor samples.

Caracterización clínico-epidemiológica de 77 niños y adolescentes infectados por el coronavirus SARS-CoV-2 / Clinical-epidemiological characterization of 77 children and adolescents infected with SARS-CoV-2 coronavirus

Introducción: Los niños también son susceptibles a la infección por SARS-CoV-2, pero sus manifestaciones clínicas son leves y la evolución en la mayoría de los casos es satisfactoria. Objetivo: Caracterizar clínica-epidemiológicamente a pacientes pediátricos infectados con el nuevo coronavirus SARS-CoV‐2. Métodos: Estudio descriptivo, transversal y retrospectivo en los primeros 77 pacientes menores de 18 años confirmados con COVID 19 e ingresados en las salas de pediatría del hospital "Dr. Luis Díaz Soto" en el período comprendido entre el 13 de marzo al 30 junio 2020. De las historias clínicas se tomaron los datos de las variables edad y sexo, comorbilidades, fuente de infección y lugar de exposición, presencia de síntomas y tiempo de aparición después del contacto y periodo en que se inició la mejoría. Resultados: Hubo discreto predominio del sexo femenino (54,5 por ciento) y los adolescentes (51,8 por ciento) más vulnerables a la infección. Se refirieron comorbilidades en 23 casos (22,8 por ciento) y el asma fue la más frecuente (10-13 por ciento). Se precisó la fuente de infección en 74 (96,1 por ciento) y 58 (75,3 por ciento) estaban asintomáticos al diagnóstico. Los síntomas más frecuentes fueron los respiratorios (tos 7-36,8 por ciento, rinorrea 5-26,3 por ciento y estornudos 4- 21,0 por ciento), le siguió la cefalea con 4 (21.0 por ciento); solo 3 presentaron fiebre (15,8 por ciento) y otros 3 anosmia-disgeusia (15,8 por ciento). La evolución fue favorable en 100,0 % de los pacientes y la mayoría estaba asintomática al 7mo. día. Conclusiones: La infección por SARS-CoV-2 se presentó sin distinción significativa de sexo, preferentemente en adolescentes, con manifestaciones leves de la enfermedad y evolución satisfactoria. No hubo fallecidos(AU)

Introduction: Children are also vulnerable to Sars-CoV-2 infections, but their clinical manifestations are slight and the evolution in most of the cases is satisfactory. Objective: Characterize in a clinical-epidemiological way pediatric patients infected with the new SARS-CoV-2 coronavirus. Methods: Descriptive, cross-sectional and retrospective study in the first 77 patients under 18 years confirmed with COVID-19 and admitted in the pediatric service of "Dr. Luis Díaz Soto" Hospital, in the period from March 13th to June 30th, 2020. From the clinical records were taken data of variables like age and sex, comorbidities, source of infection and place of exposure, presence of symptoms and time of onset after the contact, and period in which started an improvement of the disease. Results: There was a discreet predominance of female sex (54.5 percent) and the adolescents (51.8 percent) being more vulnerable to the infection. Comorbidities were noticed in 23 cases (22.8 percent) and asthma was the most frequent (10-13 percent). It was specified the source of infection in 74 patients (96.1 percent) and 58 patients (75.3 percent) were asymptomatic during the diagnosis. The most frequent symptoms were: respiratory ones (cough: 7-36.8 percent; rhinorrhoea: 5-26.3 percent; and sneezing: 4-21,0 percent); followed by cephalalgia with 4 (21,0 percent); just 3 patients presented fever (15.8 percent) and other 3 presented anosmia-dysgeusia (15.8 percent).The evolution was favorable in 100.0 percent of the patients and most of them were asymptomatic at the seventh day. Conclusions: The infection by SARS-CoV-2 was present with significative distinction of sex, more commonly in adolescents with slight manifestations of the disease and satisfactory evolution. There were no deaths(AU)

DEVELOPMENT AND VALIDATION OF A NEW LAPAROSCOPIC ENDOTRAINER FOR NEONATAL SURGERY AND REDUCED SPACES.

BACKGROUND: Pediatric laparoscopy box with sliding tray. Pediatric procedures have the difficulty of being performed in reduced spaces. Training in reduced spaces has proven to be different in complexity compared to adult laparoscopic endotrainers. AIM: To develop and validate a new neonatal/reduced-space endotrainer. METHODS: The simulator was tested and assessed by users with different skill levels and experience in laparoscopic pediatric surgery through an 8-item questionnaire. Construct validity was determined by evaluating the performance of each subject on nine exercises. RESULTS: A 10.5 x 10 x 18 cm acrylic simulator was created, with an internal working surface of 9 x 9 cm. An HD camera was incorporated, with a 0-180° range of movement. All exercises of a Basic Laparoscopic Training Program were adapted on a scale of 1:0.5 to fit in. From 49 participants, 42 (85.71%) answered the survey; 80.5% considered that the simulator reproduces similar conditions to procedures performed in children under one year of age; 61.1% thought that the simulator represents a difficulty identical to procedures performed in newborns; 73.7% considered that the neonatal simulator is more complicated than the adult simulator. Experts showed significantly better performance in all proposed exercises. CONCLUSION: The simulator has a high-quality image and design that allows training with basic tasks. The endotrainer permitted to discriminate between these different skill levels and was well evaluated by users with diverse surgical experience.

Different body mass indexes and their relation to prognosis of early-stage breast cancer in postmenopausal Mexican-Mestizo women.

It has been suggested that obesity increases the incidence of metastatic breast tumors, resulting in higher rates of recurrence, and increased mortality; for that reason, the aim of this study was to investigate if different body mass indexes modified the clinicopathologic characteristics of breast cancer; as well as, the recurrence-free survival in postmenopausal Mexican-Mestizo women. Two hundred twenty postmenopausal women with operable breast cancer were included. A structured questionnaire was applied to explore the existence of potential risk factors. Body mass index (BMI) was determined in each case and patients were grouped in accordance to their BMI in: normal weight, overweight, or obesity. Kaplan-Meier survival analysis and log-rank statistic were used to estimate recurrence-free-survival differences. Hormonal receptor(+)/HER2(-) was the most frequent breast cancer in all groups. Overweight women presented a statistically significant increased risk of this molecular subtype, with an odds ratio (OR) = 5.57; 95% confidence interval (CI) = 1.54-24.86; P = .004)). In addition, the triple-negative subtype was more frequent in women with a normal BMI in comparison to women with overweight (P = .016) or women with obesity. The heterogeneity in cancer subtypes regarding BMI was observed.