The use of rapamycin to treat vascular tumours and malformations: A single-centre experience

Objectives: To assess the safety and efficacy of rapamycin in treating children with vascular tumours and malformations. Study design: We performed a retrospective review at a large tertiary care paediatric centre to assess the efficacy and safety of using rapamycin to treat vascular tumours and malformations. Response to therapy was defined by patient-reported symptom improvement, radiological reduction in size of lesions, and/or improvement of laboratory parameters. Results: Forty-two patients (7 with vascular tumours and 35 with vascular malformations) have been treated with rapamycin. Despite 33 of 42 patients being diagnosed in the first year of life, the median age of initiating rapamycin was 11 years. Of the 38 children treated for a minimum of 4 months, 29 (76%) exhibited a clinical response. Twenty-one patients had follow-up imaging studies and of these, 16 (76%) had radiographic decrease in lesion size. Median time to demonstration of response was 49 days. All five children with vascular tumours and all three children with vascular malformations under the age of 4 years showed a clinical response. Response rate was lower for children ≥ 4 years of age (0/2, 0% for vascular tumours; 21/28, 75% for vascular malformations). No patient experienced an infection directly related to rapamycin or discontinued rapamycin due to toxicity. Conclusions: Rapamycin is safe and efficacious in most children with select vascular tumours and malformations. Young children appear to respond better, suggesting that early initiation of rapamycin should be considered

Espacio público, medio físico y percepción de inseguridad en el barrio Solanda

The objective of this academic exercise is to identify the variables of the physical environment with greater presence, and which influence the perception of insecurity within a case study in the Metropolitan District of Quito, Solanda neighborhood. To this end, the research adopts several methodological phases. The first phase focused on a literary review to build an instrument for observing the physical environment, which included all factors that have been related to the perception of insecurity; the second phase of focus groups with the inhabitants of Solanda made it possible to contrast the literary findings and collect the perceptions of the neighbors in relation to the physical environment; during the third phase, spatial audits were carried out in parks, squares, parking lots, streets and alleys. The results indicate that those variables of the physical environment with the greatest presence and influence on the perception of insecurity among the inhabitants are derived from the privatizations and invasions of public space because of the expansion of housing, to prevent free movement or entry to alleys, or by the occupation of informal commerce. In addition, a large part of the problem stems from the great densification of the neighborhood, the changes in its demographic composition and mobility based on private vehicles, which generates visual barriers on the landscape.El objetivo de este estudio es el identificar las variables del medio físico que influyen en la percepción de inseguridad y que tienen mayor presencia en el espacio público dentro de un caso de estudio en el Distrito Metropolitano de Quito, barrio Solanda. Con este fin la investigación adopta una medología estructurada en varias fases. La primera fase se centró en una revisión literaria para construir un instrumento de observación del medio físico, con todos los factores que desde la literatura se han identificado y relacionado con la percepción de inseguridad; la segunda fase de grupos focales con los habitantes de Solanda permitió contrastar los hallazgos literarios y recolectar las percepciones de los vecinos en relación con el medio físico; la tercera fase en la que, a través del instrumento de observación, se realizaron auditorías espaciales en parques, plazas, parqueaderos, calles y callejones, a fin de identificar aquellos espacios y factores de inseguridad con mayor presencia en el barrio. Los resultados indicaron que aquellas variables del medio físico con mayor presencia e influencia sobre la percepción de inseguridad entre los pobladores se derivan de las privatizaciones e invasiones del espacio público realizadas para la ampliación de viviendas, para impedir la libre circulación o ingreso a callejones o espacios públicos, o por la ocupación del comercio informal; además, gran parte de la problemática se deriva de la gran densificación del barrio, los cambios en su composición demográfica y la movilidad basada en el vehículo privado, lo que genera barreras..

Estructura genética y aptitud ambiental de poblaciones de pasto banderita [Bouteloua curtipendula (Michx.) Torr.] en Chihuahua, México

Research has increasingly centered on selecting outstanding grass genotypes for grasslands restoration, although most focuses on agronomic characteristics. Little importance has been given genotype genetic structure and environmental adaptation. An analysis was done of the genetic structure and environmental suitability of sideoats grama (Bouteloua curtipendula) populations in Chihuahua, Mexico. Fifty-one populations were evaluated through AFLP markers and analysis of their genetic structure. In a novel approach, the MaxEnt algorithm, commonly used only at the species level, was used to design models to quantify environmental aptitude of the groups generated by the genetic analysis. The STRUCTURE analysis divided the B. curtipendula populations into two different genetic groups (AMOVA; P<0.0001). Most (89 %) of the Group 1 populations are in the state’s semi-arid region while most (90 %) of the Group 2 populations are in the arid region. The MaxEnt results showed the two genetic groups to have different environmental aptitude. The climatic niche of Group 1 is mainly located in the state’s center and south, while that of Group 2 is in the center, west and northeast. Restoration programs involving B. curtipendula would benefit most from using local ecoregion-specific genotypes in areas for which they have the highest environmental aptitude.En los últimos años se han realizado diversos trabajos para seleccionar genotipos sobresalientes de pastos para restauración de pastizales. Estos trabajos se han enfocado principalmente en características agronómicas y poca importancia se ha dado a la estructura genética y adaptación ambiental de los genotipos. El objetivo fue evaluar la estructura genética y aptitud ambiental de poblaciones de pasto banderita en Chihuahua, México. Se evaluaron 51 poblaciones de pasto banderita (Bouteloua curtipendula) a través de marcadores AFLP y análisis de su estructura genética. La aptitud ambiental de los grupos genéticos que se conformaron se determinó mediante el diseño de modelos que utilizan el algoritmo de MaxEnt. Lo anterior, representa una manera novedosa de usar el algoritmo, ya que comúnmente solo se utilizada a nivel especie. El análisis STRUCTURE dividió las poblaciones de pasto banderita en dos grupos genéticos diferentes (AMOVA; P<0.0001). El 89 % de las poblaciones integradas al Grupo 1 habitan en la región semiárida y 90 % de las poblaciones del Grupo 2 se encuentran en la región árida. Los resultados del análisis de MaxEnt revelaron que los grupos genéticos tienen aptitud ambiental diferente. El nicho climático del Grupo 1 se encuentra en el centro y sur del estado, mientras que el del Grupo 2 se localiza en el centro, oeste y noreste. Por lo anterior, se concluye que los programas de restauración con pasto banderita deben realizarse con genotipos locales de cada ecorregión del Estado y en áreas con mayor aptitud ambiental

Unraveling the Potential of miRNAs from CSCs as an Emerging Clinical Tool for Breast Cancer Diagnosis and Prognosis

This research was funded by Consejería de Salud y Familias de la Junta de Andalucía (project no. PIN-0224-2019 and PEMP-0205-2022 FEDER funds); the Ministerio de Ciencia e Innovación (project no. PID2022-140151OB-C22); the Convocatoria de Proyectos Intramurales ibs.GRANADA (project no. INTRAIBS-2020-1 and INTRAIBS-2021-09) and by the Chair “Doctors Galera-Requena in cancer stem cell research” (CMC-CTS963).Breast cancer (BC) is the most diagnosed cancer in women and the second most common cancer globally. Significant advances in BC research have led to improved early detection and effective therapies. One of the key challenges in BC is the presence of BC stem cells (BCSCs). This small subpopulation within the tumor possesses unique characteristics, including tumor-initiating capabilities, contributes to treatment resistance, and plays a role in cancer recurrence and metastasis. In recent years, microRNAs (miRNAs) have emerged as potential regulators of BCSCs, which can modulate gene expression and influence cellular processes like BCSCs' self-renewal, differentiation, and tumor-promoting pathways. Understanding the miRNA signatures of BCSCs holds great promise for improving BC diagnosis and prognosis. By targeting BCSCs and their associated miRNAs, researchers aim to develop more effective and personalized treatment strategies that may offer better outcomes for BC patients, minimizing tumor recurrence and metastasis. In conclusion, the investigation of miRNAs as regulators of BCSCs opens new directions for advancing BC research through the use of bioinformatics and the development of innovative therapeutic approaches. This review summarizes the most recent and innovative studies and clinical trials on the role of BCSCs miRNAs as potential tools for early diagnosis, prognosis, and resistance.Consejería de Salud y Familias de la Junta de Andalucía PIN-0224-2019, PEMP-0205-2022 FEDERMinisterio de Ciencia e Innovación PID2022-140151OB-C22Convocatoria de Proyectos Intramurales ibs.GRANADA INTRAIBS-2020-1, INTRAIBS-2021-09Chair “Doctors Galera-Requena in cancer stem cell research” CMC-CTS96

Insomnia Disorder in Adult Attention-Deficit/Hyperactivity Disorder Patients: Clinical, Comorbidity, and Treatment Correlates

Trastorn per dèficit d'atenció i hiperactivitat; Comorbilitat; Trastorn d'insomniTrastorno por déficit de atención e hiperactividad; Comorbilidad; Trastorno de insomnioAttention deficit and hyperactivity disorder; Comorbidity; Insomnia disorderIntroduction: Several investigations have been performed on insomnia symptoms in adult attention-deficit/hyperactivity disorder (ADHD). However, the relationship between insomnia disorder and adult ADHD has been neglected in research. The main objective of the current study is to analyze the differences between adult ADHD patients with and without insomnia disorder, in terms of ADHD clinical severity, medical and psychiatric comorbidity, psychopharmacological treatment, and quality of life. Material and Methods: Two hundred and fifty-two adult patients with ADHD (mean age 37.60 ± 13.22 years; ADHD presentations—combined: 56.7%, inattentive: 39.7%, hyperactive/impulsive: 3.6%) were evaluated with an exhaustive clinical and psychological evaluation protocol including semistructured interviews (for comorbidities and ADHD assessment) and symptom rating scales for ADHD. The diagnosis of ADHD and insomnia disorder was made according to DSM-5 criteria. Furthermore, the Pittsburgh Sleep Quality Index, Insomnia Severity Index, and Epworth Sleepiness Scale were administered. Results: Insomnia disorder was found in 44.4% of adult ADHD patients and was more common in combined presentation (64.3%) and in patients with more ADHD severity. Comorbidities (both medical and psychiatric), especially mood disorders (42%), anxiety disorder (26.8%), personality disorder (39.3%), and any substance use disorder (11.6%), were associated with a higher insomnia disorder prevalence. ADHD stimulant treatment was related to lower insomnia disorder compared to patients without medication, as well as ADHD stable treatment. Additionally, worse health-related quality of life was associated with insomnia disorder. Conclusion: Insomnia disorder is highly prevalent in adult ADHD and is related to higher ADHD severity and more psychiatric and medical comorbidities. Some stimulants and stable pharmacological ADHD treatment are associated with better outcomes of insomnia disorder.The research leading to these results has received funding from the Instituto de Salud Carlos III (PI18/01788) and supported by the EU's Horizon 2020 Programme (Grant No. 667302, CoCA and Grant No. 728018 Eat2beNICE)

La Imagen y la Narrativa Como Herramienta para el Abordaje Psicosocial en Escenarios de Violencia de Dosquebradas Risaralda, Sevilla Valle, Puerto Rico Caquetá, Corozal Sucre y Nashville Tennessee.

El objetivo del Diplomado en Acompañamiento Psicosocial en Escenarios de Violencia tiene como finalidad que el estudiante en formación, a través de relatos pueda identificar las herramientas aplicadas para escenarios y contextos que han sido marcados por la violencia a raíz del conflicto armado, en procura de que pueda analizar los diferentes riesgos a nivel psicológico que sufren las víctimas del conflicto armado. En el presente informe presenta el análisis del Relato 4 “Ana Ligia”, cuya vida se vio marcada por el rigor de la violencia, sufriendo ella y su familia desplazamiento y siendo víctima de una serie de situaciones asociadas a acoso, chantaje y viendo involucrado su estado de salud. El análisis está basado en la presentación de nueve preguntas, tres estratégicas, tres circulares y tres reflexiva con el fin de realizar un abordaje a los eventos psicosociales causantes de traumas psicológicos e identificar recursos de afrontamiento. Se realiza análisis del caso “Peñas Coloradas”, donde una población ubicada al norte del departamento de Caquetá, es víctima de desplazamiento masivo, hostigamiento y son marcados como colaboradores de grupos armados, a través del análisis se identifican cuáles son los emergentes psicosociales, impactos generados en la población y se desarrollan 2 acciones de apoyo y tres estrategias psicosociales para la potenciación de los recursos como afrontamiento al conflicto. Finalmente se presenta informe analito y reflexivo a partir de la experiencia de la foto voz, realizada en cinco contextos diferentes, que abarcan territorios a nivel nacional e internacional en zonas rurales y urbanas, y que dan cuenta de la reflexión a nivel subjetivo de escenarios que han sido marcados por la violencia.The objective of the diploma in psychosocial support in scenarios of violence is intended that the student in training, through stories, can identify the tools applied for scenarios and contexts that have been marked by violence as a result of the armed conflict, in order that can analyze the different psychological risks suffered by the victims of the armed conflict. This report presents the analysis of Story 4 “Ana Ligia”, whose life was marked by the severity of violence, she and her family suffered displacement and being the victim of a series of situations associated with harassment, blackmail and seeing her involvement involved. health condition. The analysis is based on the presentation of nine questions, three strategic, three circular, and three reflective in order to approach the psychosocial events that cause psychological trauma and identify coping resources. An analysis of the case "Peñas Coloradas" is carried out, where a population located north of the department of Caquetá, is a victim of massive displacement, harassment and is marked as collaborators of armed groups. Through the analysis, the emerging psychosocial impacts are identified. generated in the population and 2 support actions and three psychosocial strategies are developed for the empowerment of resources to cope with the conflict. Finally, an analytical and reflective report is presented based on the experience of the photo voice, carried out in five different contexts, which cover territories at a national and international level in rural and urban areas, and which account for the reflection at a subjective level of scenarios that they have been marked by violence

Dietary antioxidant intake is inversely associated with 2,3-dinor oxylipin metabolites, the major excreted oxylipins in overweight and obese subjects

Cardiometabolic disease risk factors, including obesity, insulin resistance, high blood pressure, and dyslipidemia, are associated with elevated oxidative stress biomarkers like oxylipins. Increased adiposity by itself induces various isomers of this oxidized lipid family, while dietary polyphenols show benefits in its regulation. Previously, we showed that specific co-abundant microorganisms characterized the gut microbiota of Colombians and associated differentially with diet, lifestyle, obesity, and cardiometabolic health status, which led us to hypothesize that urinary oxylipins would reflect the intensity of oxidative metabolism linked to gut microbiota dysbiosis. Thus, we selected a convenience sample of 105 participants (age: 40.2 ± 11.9 years, 47.6% women), grouped according to microbiota, cardiometabolic health status, and body mass index (BMI); and evaluated 33 urinary oxylipins by HPLC-QqQ-MS/MS (e.g., isoprostanes, prostaglandins, and metabolites), paired with anthropometry and blood chemistry information and dietary antioxidants estimated from a 24-h food recall. In general, oxylipins did not show differences among individuals who differed in gut microbiota. While the unmetabolized oxylipin levels were not associated with BMI, the total content of oxylipin metabolites was highest in obese and cardiometabolically abnormal subjects (e.g., insulin resistant), mainly by prostaglandin-D (2,3-dinor-11β-PGF) and 15-F-IsoPs (2,3-dinor-15-F-IsoP and 2,3-dinor-15-epi-15-F-IsoP) metabolites. The total polyphenol intake in this cohort was 1070 ± 627 mg/day. After adjusting for body weight, the polyphenol intake was significantly higher in lean than overweight and showed an inverse association with dinor-oxylipin levels in principal component analysis. These results suggest that the 2,3-dinor-oxylipins could be more specific biomarkers associated with BMI than their parent oxylipins and that are sensitive to be regulated by dietary antioxidants.The authors thank the volunteers who agreed to participate in this study, the Colombian Ministry of science, technology, and innovation (Minciencias; grant number 832-2018), and Grupo Empresarial Nutresa. They also thank the Ibero-American Programme for Science, Technology and Development (CYTED) – Action 112RT0460 CORNUCOPIA networ

The Use of Cultured Allogenic Keratinocyte Grafting in a Patient with Epidermolysis Bullosa Simplex

Epidermolysis bullosa (EB) is a rare genetic disease that is known for continuous skin blistering caused by minor trauma. The skin blisters and bullae that develop often cause skin defects. There is no definitive treatment for EB, only symptomatic relief. We report our experience with cultured allogenic keratinocyte grafting in a newborn patient with EB simplex who had unhealed raw surfaces and was not a skin grafting candidate. The skin lesions of the patient were covered with cultured allogenic keratinocyte grafts and re-epithelialized quickly with no scarring. Allogenic keratinocyte grafting reduced pain and produced noticeable improvements in the unhealed wounds. We think that allogenic keratinocyte grafting can play an important role in the management of patients with EB simplex

Coronavirus disease 2019 in patients with rheumatic immune-mediated diseases in a single university hospital, matched case-control study and literature review

Background: COVID-19 may present different degrees of severity. Viral infections in patients with rheumatic inflammatory diseases (R-IMID) trend to present more severe disease. However, data comparing the severity of the disease between R-IMID and the general population are scarce. Objectives: To compare predisposing factors, clinical, serological features, and severity of COVID-19 infection in patients with and without R-IMID. Methods: Case-control study in a single University Hospital. We included all consecutive patients with a diagnosis of an R-IMID and COVID-19 infection up to March 31st, 2021. This cohort was compared to patients without R-IMID and not receiving immunosuppressive therapy, matched for sex and age (±5 years). Confirmed infection was defined if a patient had a positive nasopharyngeal swab for SARS-CoV-2. Severity was divided into mild, moderate, severe and critical according to the United States National Institute of Health (NIH) guidelines. Results: We included 274 R-IMID patients (185 women/89 men), mean age 59.1 ± 18 years. More frequent R-IMID were: Rheumatoid arthritis (28.8%), Psoriatic Arthritis (20.1%), axial Spondyloarthritis (12.4%), Polymyalgia Rheumatica (8%) and Systemic Lupus Erythematosus (8%). Hypertension and dyslipidemia were more frequent in patients with R-IMID. Although most of the cases were mild, critical cases and deaths were more frequent in R-IMID. When adjusted by comorbidities, no statistical differences were observed. Conclusion: R-IMID have a very similar clinical presentation when compared to the general population. There is a trend to an increased severity of the disease in patients with R-IMID

Rituximab in the treatment of interstitial lung disease associated with autoimmune diseases: experience from a single referral center and literature review

ABSTRACT: In the present study, we aimed to report our experience with rituximab (RTX) in the treatment of patients with ILD associated with AD (AD-ILD) at a single center. For this purpose, clinical characteristics, radiological findings, and pulmonary function tests (PFTs) of RTX-treated AD-ILD-patients seen from May 2016 until March 2020 at a referral center for individuals with ILD were retrospectively reviewed. Additionally, an updated literature review was conducted. A total of 26 patients (mean age 58.3 ± 11.1 years at ILD diagnosis) was included. The most common ADs related to ILD were systemic sclerosis, idiopathic inflammatory myositis (including anti-synthetase syndrome) and rheumatoid arthritis. Non-specific interstitial pneumonia (n = 12) and usual interstitial pneumonia (n = 11) were the predominant radiological patterns. The sustained improvement in PFTs was observed from the start of RTX, with a statistically significant increase in DLCO from basal to one year after RTX (mean + 4.2%, p = 0.024). Overall, there were no differences when comparing PFT outcome according to the radiological pattern or the specific type of AD. In conclusion, RTX constitutes a good therapeutic option to preserve lung function in patients with AD-ILD, regardless of the radiological pattern or the underlying AD.This research received no external funding. B.A.-M. is recipient of a and “López Albo” Post-Residency Programme funded by Servicio Cántabro de Salud. S.R.-M. is supported by funds of the RETICS Program (RD16/0012/0009) (Instituto de Salud Carlos III, co-funded by the European Regional Development Fund)