Reproductive disorders in obesity

Obesity is a major international problem related to many reproductive health problems. It is associated with multiple adverse reproductive outcomes such as infertility, ovulation dysfunction, miscarriage, preeclampsia, gestational diabetes mellitus, preterm delivery, operative delivery, and fetal growth disorders. Despite this, there is no absolute consensus about the effect of obesity on infertility treatment specially because it is unclear which mechanism contributes the most to subfecundity, and it is likely a cumulative process. Female obesity adversely affects reproductive function through alterations in the hypothalamic- pituitary-ovarian axis, oocyte quality, and endometrial receptivity. Once pregnant, the obese women have higher risk of adverse pregnancy outcomes. Weight loss improves reproductive potential in obese patients, however, changing eating behavior and maintenance of ideal weight is difficult and hard to achieve not only per se but also because many of the infertile patients who attend infertility clinics at an age >30 years may not have much time to wait until they can lose weight because age itself is the major factor of declining fertility. This makes it imperative to find a consensus for medical treatment of obese patients. Obstetrician gynecologists need to be aware of the negative impact of obesity on reproductive function so that they appropriately counsel their patients. Further work is needed to clarify the underlying physiopathology responsible for adverse effects of obesity on reproduction so that novel treatment approaches may be developed.Fil: Elia, Evelin Mariel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Fisiología, Biología Molecular y Neurociencias. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Fisiología, Biología Molecular y Neurociencias; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Biodiversidad y Biología Experimental. Laboratorio de Biología del Desarrollo; ArgentinaFil: Bazzano, María Victoria. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Fisiología, Biología Molecular y Neurociencias. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Fisiología, Biología Molecular y Neurociencias; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Biodiversidad y Biología Experimental. Laboratorio de Biología del Desarrollo; ArgentinaFil: Quintana, Ramiro. Procrearte; ArgentinaFil: Paz, Dante Agustin. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Fisiología, Biología Molecular y Neurociencias. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Fisiología, Biología Molecular y Neurociencias; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Biodiversidad y Biología Experimental. Laboratorio de Biología del Desarrollo; Argentin

Fluid management during video-assisted thoracoscopic surgery for lung resection: A randomized, controlled trial of effects on urinary output and postoperative renal function

BackgroundIncreased perioperative fluid administration is an independent risk factor for lung injury after pulmonary resection. In clinical practice, fluid therapy is heavily guided by urinary output; however, diuretic response to plasma volume expansion has been reported to be blunted during anesthesia and surgery. We therefore hypothesized that in patients undergoing video-assisted thoracoscopic surgery, different regimens of intraoperative fluid management would not affect urinary output as would be expected in the nonsurgical scenario. Moreover, a restrictive perioperative fluid approach, as indicated in these operations, will not harm renal function.MethodsOne hundred two patients undergoing video-assisted thoracoscopic surgery were randomly allocated to receive intraoperatively either high (8 mL/[kg · h]; n = 51) or low (2 mL/[kg · h]; n = 51) amounts of Ringer's lactate solution. The primary end point was intraoperative urinary output. Secondary end points included postoperative creatinine serum levels and postoperative complication rate.ResultsDemographic and surgical data were comparable between groups. Regardless of the intraoperatively fluids administered (mean ± SD, 2131 ± 850 vs 1035 ± 652 mL in high and low groups, respectively; P < .0001), urinary output was similar (median 300 mL). Perioperative creatinine serum levels decreased significantly postoperatively and were not significantly different among the groups.ConclusionsIn patients undergoing video-assisted thoracoscopic surgery, intraoperative urinary output and postoperative renal function are not affected by administration of fluids in the range of 2 to 8 mL/(kg · h). The clinical practice of administering fluids to enhance diuresis in the perioperative period should therefore be abandoned

Factores de riesgo maternos, vinculados a partos prematuros, bajo peso al nacer, otros defectos congénitos en Arcatao, Huizúcar y Estanzuelas en el periodo de mayo-junio del 2018

Se presentan los factores de riesgo asociados con más frecuencia a la maternidad; para lo cual, se obtiene como resultado, despúes de determinado período de investigación, que, las afecciones más frecuentes durante la gestación son las infecciones de vías urinarias (mayormente) y las infecciones vaginales; y en tercer lugar, como factor crónico adquirido previamente, la obesida

Metformin decreases the incidence of ovarian hyperstimulation syndrome: an experimental study

Background: In assisted reproduction cycles, gonadotropins are administered to obtain a greater number of oocytes. A majority of patients do not have an adverse response; however, approximately 3-6% develop ovarian hyperstimulation syndrome (OHSS). Metformin reduces the risk of OHSS but little is known about the possible effects and mechanisms of action involved. Objective: To evaluate whether metformin attenuates some of the ovarian adverse effects caused by OHSS and to study the mechanisms involved. Material and methods: A rat OHSS model was used to investigate the effects of metformin administration. Ovarian histology and follicle counting were performed in ovarian sections stained with Masson trichrome. Vascular permeability was measured by the release of intravenously injected Evans Blue dye (EB). VEGF levels were measured by commercially immunosorbent assay kit. COX-2 protein expression was evaluated by western blot and NOS levels were analyses by immunohistochemistry. Results: Animals of the OHSS group showed similar physiopathology characteristics to the human syndrome: increased body weight, elevated progesterone and estradiol levels (P<0.001), increased number of corpora lutea (P<0.001), higher ovarian VEGF levels and vascular permeability (P<0.001 and P<0.01); and treatment with metformin prevented this effect (OHSS+M group; P<0.05). The vasoactive factors: COX-2 and NOS were increased in the ovaries of the OHSS group (P<0.05 and P<0.01) and metformin normalized their expression (P<0.05); suggesting that metformin has a role preventing the increased in vascular permeability caused by the syndrome. Conclusion: Metformin has a beneficial effect preventing OHSS by reducing the increase in: body weight, circulating progesterone and estradiol and vascular permeability. These effects of metformin are mediated by inhibiting the increased of the vasoactive molecules: VEGF, COX-2 and partially NOS. Molecules that are increased in OHSS and are responsible for a variety of the symptoms related to OHSS.Fil: Elia, Evelin Mariel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Fisiología, Biología Molecular y Neurociencias. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Fisiología, Biología Molecular y Neurociencias; ArgentinaFil: Quintana, Ramiro. Procrearte Medicina Reproductiva y Molecular; ArgentinaFil: Carrere, Carlos. Procrearte Medicina Reproductiva y Molecular; ArgentinaFil: Bazzano, María Victoria. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Biodiversidad y Biología Experimental; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Rey Valzacchi, Gastón. Procrearte Medicina Reproductiva y Molecular; ArgentinaFil: Paz, Dante Agustin. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Fisiología, Biología Molecular y Neurociencias. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Fisiología, Biología Molecular y Neurociencias; ArgentinaFil: Pustovrh, María Carolina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Fisiología, Biología Molecular y Neurociencias. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Fisiología, Biología Molecular y Neurociencias; Argentina. Universidad del Valle. Fundación Samanea; Colombi

Parents' views and experiences of the Home Mathematics Environment: A cross-country study

The purpose of the current study was to qualitatively explore the home mathematical environment across two regions in two different countries (i.e., Cuba and Mexico), replicating a qualitative study previously conducted in Northern Ireland (NI), United Kingdom (UK; Cahoon et al., 2017). Semi-structured interviews with parents/caregivers of children (3-5-year-olds) in both Mexico (n = 13) and Cuba (n = 40) were completed to investigate their views, experiences and attitudes towards the home mathematical environment. Thematic analysis was used to explore themes relevant to the home mathematical environment. Three consistent themes were found in the Mexican and Cuban data: Numeracy Environment Structure, Expectations and Attitudes and Views of Technology. Two unique themes were found in the Mexico data: Interactions Related to Reading or Mathematics, and Child’s Attitudes in Relation to Mathematics. One unique theme was found in the Cuban interviews: Interactions for Learning. Although diverse themes were identified, consistencies were also observed. This suggests that some home numeracy practices may be universal in nature. This research increases understanding of human development in context

Comparative Study of Infliximab Versus Adalimumab in Refractory Uveitis Due to Behçet's Disease: National Multicenter Study of 177 Cases

Objective: To compare the efficacy of infliximab (IFX) versus adalimumab (ADA) as a first-line biologic drug over 1 year of treatment in a large series of patients with refractory uveitis due to Behçet's disease (BD). Methods: We conducted an open-label multicenter study of IFX versus ADA for BD-related uveitis refractory to conventional nonbiologic treatment. IFX or ADA was chosen as the first-line biologic agent based on physician and patient agreement. Patients received 3-5 mg/kg intravenous IFX at 0, 2, and 6 weeks and every 4-8 weeks thereafter, or 40 mg subcutaneous ADA every other week without a loading dose. Ocular parameters were compared between the 2 groups. Results: The study included 177 patients (316 affected eyes), of whom 103 received IFX and 74 received ADA. There were no significant baseline differences between treatment groups in main demographic features, previous therapy, or ocular sign severity. After 1 year of therapy, we observed an improvement in all ocular parameters in both groups. However, patients receiving ADA had significantly better outcomes in some parameters, including improvement in anterior chamber inflammation (92.31% versus 78.18% for IFX; P = 0.06), improvement in vitritis (93.33% versus 78.95% for IFX; P = 0.04), and best-corrected visual acuity (mean ± SD 0.81 ± 0.26 versus 0.67 ± 0.34 for IFX; P = 0.001). A nonsignificant difference was seen for macular thickness (mean ± SD 250.62 ± 36.85 for ADA versus 264.89 ± 59.74 for IFX; P = 0.15), and improvement in retinal vasculitis was similar between the 2 groups (95% for ADA versus 97% for IFX; P = 0.28). The drug retention rate was higher in the ADA group (95.24% versus 84.95% for IFX; P = 0.042). Conclusion: Although both IFX and ADA are efficacious in refractory BD-related uveitis, ADA appears to be associated with better outcomes than IFX after 1 year of follow-up

Revisión de 13 especies de la familia Triatominae (Hemiptera: Reduviidae) vectores de la enfermedad de Chagas, en México

Vectors of Trypanosoma cruzi, parasite responsible for Chagas disease, are divided in intradomestic, peridomestic andsylvatic. The intradomestic are Triatoma barberi and Triatoma dimidiata, two species that represent the highest healthrisk among the Mexican population. Triatoma dimidiata is a species found mainly inside human habitats, but inYucatan, it corresponds to the peridomicile vectors. Also in the peridomicile most of Chagas disease vectors arefound: Meccus bassolsae, M. longipennis, M. mazzottii, M pallidipennis, M. phyllosomus, M picturata, Triatomagerstaeckeri, T mexicana, T rubida, Dipetalogaster máxima (the last two are in the process of becoming adapted tothe domicile), Panstrongylus rufotuberculatus which occasionally enters the domicile in its adult stage, and Rhodniusprolixus, which is practically controlled in the country. Peridomestic vectors are of lower risk in the transmissiondynamics, as compared to the intradomestic ones. For the control of the intradomestic vectors, health educationprograms, improvements of housing, and the use of pesticides are essential To control the peridomestic vectors, healtheducation programs are required, as well as the use of mosquito nets on doors and windows and around beds, asidefrom cementing the stone wall fences.Los transmisores de Trypanosoma cruzi, flagelado causante de la enfermedad, se dividen en intradomiciliados,peridomiciliados y silvestres. Entre los intradomiciliados se encuentran, Triatoma barberi y Triatoma dimidiata, queson los que representan un mayor riesgo para la Salud Pública, en México. Aunque Triatoma dimidiata se encuentraprincipalmente dentro de la vivienda, en Yucatán tiene un comportamiento peridomiciliar, dentro de este grupo seencuentran la mayoría de los transmisores de la enfermedad de Chagas Meccus longipennis, M. mazzottii, M.pallidipennis, M. phyllosomus, M. picturatus, Triatoma gerstaeckeri, T. mexicana, T. rubida, Dipetalogaster máxima,Panstrongylus rufotuberculatus y Rhodnius prolixus. Los transmisores peridomiciliados son de menor riesgo en ladinámica de transmisión comparados con los intradomiciliados. Para el control de los transmisores intradomiciliados,se deben emplear programas de educación para la salud, mejoramiento de vivienda e insecticidas; mientras que paralos vectores visitantes o peridomiciliados, son necesarios programas de educación para la salud, uso de mosquiteros,pabellones y cementación de las bardas de piedra

Stratification of radiosensitive brain metastases based on an actionable S100A9/RAGE resistance mechanism

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.Whole-brain radiotherapy (WBRT) is the treatment backbone for many patients with brain metastasis; however, its efficacy in preventing disease progression and the associated toxicity have questioned the clinical impact of this approach and emphasized the need for alternative treatments. Given the limited therapeutic options available for these patients and the poor understanding of the molecular mechanisms underlying the resistance of metastatic lesions to WBRT, we sought to uncover actionable targets and biomarkers that could help to refine patient selection. Through an unbiased analysis of experimental in vivo models of brain metastasis resistant to WBRT, we identified activation of the S100A9-RAGE-NF-κB-JunB pathway in brain metastases as a potential mediator of resistance in this organ. Targeting this pathway genetically or pharmacologically was sufficient to revert the WBRT resistance and increase therapeutic benefits in vivo at lower doses of radiation. In patients with primary melanoma, lung or breast adenocarcinoma developing brain metastasis, endogenous S100A9 levels in brain lesions correlated with clinical response to WBRT and underscored the potential of S100A9 levels in the blood as a noninvasive biomarker. Collectively, we provide a molecular framework to personalize WBRT and improve its efficacy through combination with a radiosensitizer that balances therapeutic benefit and toxicity.info:eu-repo/semantics/publishedVersio

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection