Arterial Hypertension and Tyrosine Kinase Inhibitors in Chronic Myeloid Leukemia: A Systematic Review and Meta-Analysis

Background: Off-target effects in chronic myeloid leukemia (CML) patients treated with tyrosine kinase inhibitors (TKIs) are associated with cardiovascular toxicity. Hypertension represents an important cardiovascular complication and, if not appropriately managed, can contribute to developing thrombotic events. Third-generation TKI ponatinib is associated with hypertension development, and its use is more restricted than in the past. Few data are reported for second-generation TKI, nilotinib, dasatinib, and bosutinib. The aim of this article was to evaluate with a systematic review and meta-analysis the real incidence of hypertension in CML patients treated with second- or third-generation TKI. Methods: The PubMed database, Web of Science, Scopus, and ClinicalTrials.gov were systematically searched for studies published between January 1, 2000, and January 30, 2021; the following terms were entered in the database queries: Cardiovascular, Chronic Myeloid Leukemia, CML, Tyrosine kinases inhibitor, TKI, and Hypertension. The study was carried out according to the Preferred Reporting Items for Systematic and Meta-Analyses (PRISMA) statement. Results: A pooled analysis of hypertension incidence was 10% for all new-generation TKI, with an even higher prevalence with ponatinib (17%). The comparison with the first-generation imatinib confirmed that nilotinib was associated with a significantly increased risk of hypertension (RR 2; 95% CI; 1.39-2.88, I2=0%, z=3.73, p=0.0002). The greatest risk was found with ponatinib (RR 9.21; 95% CI; 2.86-29.66, z=3.72, p=0.0002). Conclusion: Hypertension is a common cardiovascular complication in CML patients treated with second- or third-generation TKI

Reinforcement learning applications in environmental sustainability: a review

Environmental sustainability is a worldwide key challenge attracting increasing attention due to climate change, pollution, and biodiversity decline. Reinforcement learning, initially employed in gaming contexts, has been recently applied to real-world domains, including the environmental sustainability realm, where uncertainty challenges strategy learning and adaptation. In this work, we survey the literature to identify the main applications of reinforcement learning in environmental sustainability and the predominant methods employed to address these challenges. We analyzed 181 papers and answered seven research questions, e.g., “How many academic studies have been published from 2003 to 2023 about RL for environmental sustainability?” and “What were the application domains and the methodologies used?”. Our analysis reveals an exponential growth in this field over the past two decades, with a rate of 0.42 in the number of publications (from 2 papers in 2007 to 53 in 2022), a strong interest in sustainability issues related to energy fields, and a preference for single-agent RL approaches to deal with sustainability. Finally, this work provides practitioners with a clear overview of the main challenges and open problems that should be tackled in future research

Assessment of Yield and Quality of Eggplant (Solanum melongena L.) Fruits Improved by Biodegradable Mulching Film in Two Different Regions of Southern Italy

Low-density polyethylene (LDPE) mulching films have an important function in crop cultivation; at the end of their life, however, their removal and disposal become both an economic and environmental problem. One possible alternative to low-density polyethylene (LDPE) mulch is provided by certified soil-biodegradable mulch films, such as those produced by Novamont and commercially available under the trade name MaterBi (R). MaterBi is a biodegradable thermoplastic material made with starch and a biodegradable copolyester based on proprietary technology. In this study, we compared two biodegradable MaterBi (R)-based films (commercial and experimental films) with bare soil and a low-density polyethylene to evaluate their effect on yield and on a number of qualitative characteristics (organoleptic and nutraceutical composition) of eggplant fruits (cv Mirabelle F1) grown in two different regions in Southern Italy (Sicily and Campania). In our study, the use of biodegradable MaterBi (R) films improved not only yield and production parameters, such as the number and average weight of fruits, but also lipophilic and hydrophilic antioxidant activity and phenolic and ascorbic acid content. For many parameters, responses differed according to the cultivation environment and, in particular, the site's pedoclimatic conditions. Our results suggest that biodegradable MaterBi (R)-based mulching films are a potentially valid alternative to traditional LDPEs, providing the production and quality benefits reported above and promoting environmental sustainability, thanks to their positive biodegradable properties

Asociación entre enfermedad de hígado graso no alcohólico y aterosclerosis subclínica

Introduction: non-alcoholic fatty lever disease is linked to atherosclerosis due to the latest´s risk factors. There are also tendencies that affirm that there is a different factor on its pathogeny. The subclinical atherosclerosis is a preventive medicine concept, and looking for it can help finding clues for future irreversible damage.Objective: to determine the association between subclinical atherosclerosis in dyslipidemic patients with non-alcoholic fatty lever disease. Method: a descriptive, cross-sectional study was carried out in a population of 114 dyslipidemic patients with non-alcoholic fatty lever disease in the dyslipoproteinemias consultation at the Surgical Clinical Hospital ¨Hermanos Amejeiras¨ from 2016 to 2019.Results:  mean age was 52.9 ± 12.4 years, with male patients’ predominance. 62 patients showed thickening in the intima-media wider than 1mm in echocardiography, and just 8 patients had atheroma plaque in the carotid artery. The frequency of the altered lipidic profile was due to hypertriglyceridaemia and HDL cholesterol. Conclusions: no link was found between non-alcoholic fatty lever disease and subclinical atherosclerosis. Through the analysis, atherosclerosis was linked to variables as age and family history of ischemic heart disease. There is no association between subclinical atherosclerosis and the degree of progression in the non-alcoholic fatty lever disease given by the APRI index.Introducción: la enfermedad de hígado graso no alcohólico está asociada con la aterosclerosis como consecuencia de los factores de riesgo que la acompañan. Hay tendencias que apoyan que es un factor independiente en su patogenia. La aterosclerosis subclínica es un concepto de medicina preventiva y su búsqueda permite marcar la aparición futura de daños irreversibles. Objetivo: determinar la asociación de aterosclerosis subclínica en pacientes dislipidémicos con enfermedad de hígado graso no alcohólico. Método: se realizó un estudio descriptivo, transversal en 114 pacientes dislipidémicos con enfermedad de hígado graso no alcohólico de la consulta de dislipoproteinemias en el Hospital Clínico Quirúrgico “Hermanos Ameijeiras” en el período comprendido entre los años 2016 al 2019.Resultados: la media de edad fue de 52,9 ± 12,4 años con predominio del sexo masculino. En ecocardiografía, 62 pacientes con enfermedad de hígado graso no alcohólico presentaron aumento del grosor de la íntima media mayor de 1mm y solo 8 pacientes tenían placa de ateroma de la arteria carotídea. La frecuencia del perfil lipídico alterado fue a expensas de hipertrigliceridemia y de la HDL colesterol.Conclusiones: no existió asociación entre la enfermedad de hígado graso no alcohólico con aterosclerosis subclínica; mediante el análisis multivariado se encontró asociación franca de la aterosclerosis subclínica con variables como la edad y el antecedente familiar de cardiopatía isquémica. No hay asociación de aterosclerosis subclínica con el grado de progresión de enfermedad de hígado graso no alcohólico dado por el índice de APRI

Links between non-alcoholic fatty lever disease and subclinical atherosclerosis

Introduction: non-alcoholic fatty lever disease is linked to atherosclerosis due to the latest´s risk factors. There are also tendencies that affirm that there is a different factor on its pathogeny. The subclinical atherosclerosis is a preventive medicine concept, and looking for it can help finding clues for future irreversible damage. Objective: to determine the association between subclinical atherosclerosis in dyslipidemic patients with non-alcoholic fatty lever disease. Method: a descriptive, cross-sectional study was carried out in a population of 114 dyslipidemic patients with non-alcoholic fatty lever disease in the dyslipoproteinemias consultation at the Surgical Clinical Hospital ¨Hermanos Amejeiras¨ from 2016 to 2019. Results:  mean age was 52.9 ± 12.4 years, with male patients’ predominance. 62 patients showed thickening in the intima-media wider than 1mm in echocardiography, and just 8 patients had atheroma plaque in the carotid artery. The frequency of the altered lipidic profile was due to hypertriglyceridaemia and HDL cholesterol. Conclusions: no link was found between non-alcoholic fatty lever disease and subclinical atherosclerosis. Through the analysis, atherosclerosis was linked to variables as age and family history of ischemic heart disease. There is no association between subclinical atherosclerosis and the degree of progression in the non-alcoholic fatty lever disease given by the APRI index

Overweight in schoolchildren and nutrient intake

Introduction: According to the World Health Organization (WHO), one of the most serious health problems of the 21st century is childhood obesity. In 2016, more than 400 million children and adolescents between the age of 5 and 19 were overweight or obese. The aim of this study is to evaluate the consumption, habits and dietary practices of schoolchildren who suffer from malnutrition due to overweight or obesity. Methods: descriptive, correlational and prospective study using a quantitative approach. The sample size was 82 girls and boys who met the inclusion criteria between 8 and 14 years of a public institution of basic education in Barranquilla. Results: schoolchildren of both sexes had a high prevalence of obesity, particularly in the female group (76.44%). A dietary interview using the frequency of food consumption method showed a moderate consumption of fruits and vegetables, as well as a high consumption of sugary drinks, fried foods, cookies and sweets, and a low intake of water. Regarding eating habits and practices, it was reported that a high percentage of schoolchildren receive diets and purchase cookies, ice cream, sugary drink or juices and salty snacks. Discussion: a a study revealed in 56 schoolchildren evaluated the prevalence of overweight of Spanish schoolchildren according to sex, thus showing a higher prevalence of overweight in girls (21.9%) than in boys, (10.1%) while the prevalence go obesity was higher in boys (24.5%) than in girls (9.7%). A systematic analysis reported in a population of children and adults from 1980 to 2013, finding a prevalence of overweight and obesity in boys (26.3% and 9.4%, respectively) and girls (27.3% and 8.3%). Our study presents excessive figures related to obesity mainly in schoolgirls (76.44%). Conclusion: Our data show a relationship between the prevalence of overweight and obesity and poor consumption and eating habits and practices

Factores desencadenantes del pie diabético en pacientes con Diabetes Mellitus

Introduction: diabetes mellitus constitutes a public health problem worldwide characterized by its high rate of morbidity and mortality, high costs and chronic complications.Objective: to determine the factors associated with the appearance of diabetic foot in diabetic patients.Material and method: an observational case-control study was carried out to determine the influence of some risk factors that lead to a diabetic foot in diabetic patients at the Asdrúbal López Vázquez Polyclinic, Guantánamo in 2019. The universe of study was It was made up of a total of 52 diabetic patients, belonging to the two basic work groups of the polyclinic, and a group called control was also consigned, consisting of 104 diabetic patients included in the same health area and study period.Results: age over 50 years (p = 0,05),), smoking habit (p = 0,01), hypercholesterolemia (p = 0,02), obesity (p = 0,03), hypertension were significant in a bivariate way. Blood glucose (p = 0,02), lack of glycemic control (p = 0,01), non-adherence to hypoglycemic treatment (OR = 0,01), onychomycosis in the feet (p = 0,01) and use of inappropriate footwear (p = 0,02).Conclusions: diabetics over 50 years of age, who present an increase in their body weight above normal, and an inadequate control of glycemia, are more likely to suffer from diabetic foot. Therefore, all the necessary hygienic-dietetic measures must be taken to avoid the appearance of this complication and thus extend the life of these patients.Introducción: la diabetes mellitus constituye un problema de salud pública a nivel mundial caracterizada por su alta tasa de morbimortalidad, altos costos y complicaciones crónicas.Objetivo: determinar los factores asociados a la aparición de pie diabético en los pacientes diabéticos. Material y método: se realizó un estudio observacional, analítico, de tipo casos y controles para determinar la influencia de algunos factores de riesgos que conllevan a un pie diabético en los pacientes diabéticos del Policlínico Asdrúbal López Vázquez, Guantánamo en el año 2019. El universo de estudio se conformó por un total de 52 pacientes diabéticos, pertenecientes a los dos grupos básicos de trabajo del policlínico y se consignó además, un grupo que se denominó control, constituido por 104 pacientes diabéticos incluidos en la misma área de salud y período de estudio. Se utilizó estadística descriptiva e inferencial.Resultados: resultaron significativas de forma bivariada, la edad mayor de 50 años (p=0,05), el hábito de fumar (p=0,01), la hipercolesterolemia (p=0,02), la obesidad (p=0,03), la hipertensión arterial (p=0,02), el no control de la glucemia (p=0,01), la no adhesión al tratamiento hipoglicemiante (OR=0,01), la onicomicosis en los pies (p=0,01) y el uso del calzado inadecuado (p=0,02).Conclusiones: los diabéticos mayores de 50 años de edad, que presenten aumento de su peso corporal por encima de lo normal, y un inadecuado control de la glucemia, son más propensos de padecer de pie diabético. Por lo que se debe tomar todas las medidas higiénico-dietéticas necesarias para evitar la aparición de esta complicación

Caracterización clínico-epidemiológica de pacientes con cáncer bucal

Introduction: oral cancer occupies one of the top 10 cancer incidence locations in the world. Objective: to characterize clinically and epidemiologically patients with oral cancer at the Celia Sánchez Manduley Clinical-Surgical Hospital. Material and method: an observational, cross-sectional descriptive study was carried out of patients diagnosed with cancer in the oral cavity at the Celia Sánchez Manduley Clinical-Surgical Hospital in Manzanillo, during the period from January 1, 2017 to December 31, 2018. The universe was 56 patients. Descriptive statistics were used. Results: it was found that the predominant age was 70-79 years for 33.92%, with a predominance of males (55.35%). Smoking was the risk factor that stood out, there was a predominance of mixed race patients represented by 23 patients (41.07%), ulceration (55.35%) was a more frequent clinical manifestation. Squamous cell carcinoma was the one that affected the most patients. The predominant clinical stage was I with 32 patients (57.14%). Conclusions: with a good identification of the risk factors and the clinical manifestations of oral cancer developed by the Integral General Physician, in conjunction with the stomatologists of the health areas, we can prevent the advanced stages of said affection; in order to achieve greater survival in these patients. Introducción: el cáncer bucal ocupa una de las 10 primeras localizaciones de incidencia de cáncer en el mundo.Objetivo: caracterizar clínica y epidemiológicamente a los pacientes con cáncer bucal en el Hospital Clínico-Quirúrgico Celia Sánchez Manduley.Material y método: se realizó un estudio observacional, descriptivo y transversal de los pacientes diagnosticados con cáncer en la cavidad bucal en el Hospital Clínico-Quirúrgico Celia Sánchez Manduley de Manzanillo, durante el periodo del 1 de enero del 2017 al 31 de diciembre del  2018. El universo estuvo constituido por 56 pacientes. Se emplearon estadígrafos descriptivos.  Resultados: se encontró que la edad predominante fue de 70-79 años para un 33,92 %, con predominio del sexo masculino (55,35 %). El tabaquismo fue el factor de riesgo que se destacó, hubo un predominio de los pacientes de raza mestiza representado por 23 pacientes (41,07 %), incidió con mayor frecuencia la ulceración (55,35 %) como manifestación clínica. El carcinoma epidermoide fue el que más pacientes afectó. La etapa clínica predominante fue la I con 32 pacientes (57,14 %).Conclusiones: con una buena identificación de los factores de riesgos y las manifestaciones clínicas del cáncer bucal desarrollada por el Médico General Integral, en conjuntos con los estomatólogos de las áreas de salud podemos prevenir los estadios avanzados de dicha afección; para así lograr una mayor supervivencia en estos pacientes.