Mielolipoma suprarrenal atípico en paciente con hipertensión arterial resistente

Adrenal myelolipoma is a slow-growing tumour, composed of fatty tissue and haematopoietic elements, typically non-secretory, although a low percentage is associated with endocrine pathology. We present the case of a 35-year-old man who, during the study of resistant arterial hypertension, was diagnosed with a large adrenal incidentaloma with an image congruent with adrenal myelolipoma, whose analytical determinations were anodyne, suggesting a non-functioning adenoma. After surgical resection, the anatomopathological study of the mass revealed pheochromocytoma cells, which produce catecholamines and are responsible for the patient's high blood pressure resistance.El mielolipoma suprarrenal es un tumor de lento crecimiento, compuesto por tejido graso y elementos hematopoyéticos, típicamente no secretor, aunque un bajo porcentaje asocia coexistencia con patología endócrina. Presentamos el caso de un varón de 35 años al que, durante el estudio de hipertensión arterial resistente, se le diagnostica de incidentaloma suprarrenal de gran tamaño con imagen congruente con mielolipoma suprarrenal, cuyas determinaciones analíticas eran anodinas sugiriendo un adenoma no funcionante. Tras la resección quirúrgica, el estudio anatomopatológico de dicha masa reveló células de feocromocitoma, productor de catecolaminas, que condiciona la resistencia de la hipertensión arterial del paciente

Transverse Cervicothoracic Stabbing: Multidisciplinary Management of a Surgical Emergency

Tracheobronchial injuries are closely related to orotracheal intubations and chest traumas. Stabbing injuries are very rare and often life threatening because of the damage to vital structures such as the respiratory tract and large arterial or venous vessels. Early diagnosis and treatment of penetrating neck injuries increase survival rates. We report a case of the tracheobronchial section with a penetrating stabbing wound on the left laterocervical area associated with contralateral pneumothorax, requiring urgent surgical pulmonary repair, tracheal suture, and tracheotomy. Prompt action with a multidisciplinary approach resulted in a favorable outcome

Loss of smell and taste can accurately predict COVID-19 infection: a machine-learning approach

The COVID-19 outbreak has spread extensively around the world. Loss of smell and taste have emerged as main predictors for COVID-19. The objective of our study is to develop a comprehensive machine learning (ML) modelling framework to assess the predictive value of smell and taste disorders, along with other symptoms, in COVID-19 infection. A multicenter case-control study was performed, in which suspected cases for COVID-19, who were tested by real-time reversetranscription polymerase chain reaction (RT-PCR), informed about the presence and severity of their symptoms using visual analog scales (VAS). ML algorithms were applied to the collected data to predict a COVID-19 diagnosis using a 50-fold cross-validation scheme by randomly splitting the patients in training (75%) and testing datasets (25%). A total of 777 patients were included. Loss of smell and taste were found to be the symptoms with higher odds ratios of 6.21 and 2.42 for COVID-19 positivity. The ML algorithms applied reached an average accuracy of 80%, a sensitivity of 82%, and a specificity of 78% when using VAS to predict a COVID-19 diagnosis. This study concludes that smell and taste disorders are accurate predictors, with ML algorithms constituting helpful tools for COVID-19 diagnostic prediction.Junta de Andalucí

El huerto ecopónico: un recurso efectivo para fomentar en los estudiantes una actitud pro ambiental y educación alimentaria

The objective was to implement the ecoponic orchard as a strategy to improve a pro-environmental attitude and food education in primary, secondary, high school and university students in Tenosique Tabasco, Mexico. The study lasted seven months, with the harvest indicating the first products 70 days after implementing the ecoponic orchard. To analyze the current state and change in attitude level, a questionnaire with 20 questions and four response levels was applied at the beginning and at the end of the study. The questionnaire was divided into three categories, 1) liking to be in contact with nature (CN), 2) liking for studying nature (EN) and 3) liking for working in nature (TN). The results indicated that at the beginning of the study, the students with a higher educational level had less pro-environmental attitude and low interest in orcharding. However, at the end of the study, the results indicated a significant positive change in attitudes in the four educational levels, with the highest levels being obtained by primary school students, followed by secondary school students, then high school students and finally university students. It is concluded that the ecoponic garden in the schoolyard is an effective resource to promote in students a pro-environmental attitude and skills for food production.El objetivo fue implementar el huerto ecopónico como estrategia para mejorar la actitud proambiental y educación alimentaria en estudiantes de nivel primaria, secundaria, preparatoria y universidad en Tenosique Tabasco, México. El estudio tuvo una duración de siete meses, indicando la cosecha los primeros productos a los 70 días de haber implementado del huerto ecopónico. Para analizar el estado actual y cambios de nivel de actitud, se aplicó al inicio y al finalizar el estudio un cuestionario con 20 preguntas y cuatro niveles de respuesta. El cuestionario se dividió en tres categorías, 1) gusto de estar en contacto con la naturaleza (CN), 2) gusto por estudiar la naturaleza (EN) y 3) gusto por trabajar en la naturaleza (TN). Los resultados indicaron que al inicio del estudio, los estudiantes de mayor nivel educativo presentaban menor actitud proambiental y bajo interés por el cultivo del huerto. Sin embargo, al finalizar el estudio, los resultados indicaron un cambio positivo significativo en los cuatro niveles educativos, obteniendo los niveles más alto los estudiantes de primaria, seguido por estudiantes de secundaria, luego los de preparatoria y por último los universitarios. Se concluye que el huerto ecopónico en el patio de la escuela es un recurso efectivo para fomentar en los estudiantes una actitud proambiental y habilidades para la producción de alimentos

Tissue-specific Activated Regulatory Lymphocytes Immunophenotype in Chronic Rhinosinusitis with Nasal Polyps

Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a chronic inflammatory disease that affects about 5% of the general global population [...]This work was supported by Grant PI-0212-2017, PIGE-0367-2019 and RH-0048-2021 of the “Consejería de Salud y Familias, Junta de Andalucía” Spain.Peer reviewe

Red de reservas marinas para la Región de las Grandes Islas, Golfo de California: protocolo del proyecto de planeación y reporte de los talleres del equipo de planeación [Marine reserves network for the Midriff Islands Region, Gulf of California, Mexico: planning protocol and progress report to the WWF Mexico & Carlos Slim Foundation Alliance]

La Región de las Grandes Islas (RGI), localizada en el acuario del mundo, el Golfo de California, es reconocida a nivel mundial por su espectacular belleza, diversidad y productividad; en ocasiones se le ha denominada como "las Galápagos del Hemisferio Norte" (Figura 1). En sus 45 islas, incluyendo las dos más grandes de México, Tiburón e Isla Ángel de la Guarda, se han registrado más de 400 especies de plantas, anfibios, reptiles y mamíferos terrestres, algunas de ellas endémicas a una o varias de las islas. En algunas de estas islas, como Rasa y San Pedro Mártir, llegan a anidar cientos de miles de aves marinas. Alrededor de este gran archipiélago, se pueden observar hasta 23 especies de mamíferos marinos, incluyendo la súper agregación de cachalotes en la cuenca San Pedro Mártir. Así como también es un sitio usado por cinco especies de tortugas marinas para hibernar y alimentarse. [English] In collaboration with researchers, agencies and NGOs, we aim to guide the design and implementation of a network of marine reserves for Midriff Islands, Gulf of California, a marine conservation hotspot. The area is one of the most important fishing regions in Mexico and livelihoods of coastal communities are threatened by depletion of fish stocks and climate change. The project aims to develop a practical approach to design networks of marine reserves that consider ecological connectivity and the effects of climate change. The project is an example of interdisciplinary and collaborative applied research, including over 25 researchers and managers from NGOs (COBI, Pronatura), universities (James Cook University, The University of Queensland, Arizona State University, SCRIPPS, The University of Arizona), and national (Mexico’s Commissions for Protected Areas and Biodiversity) and international agencies (NOAA)

Role of NAFLD on the Health Related QoL Response to Lifestyle in Patients With Metabolic Syndrome: The PREDIMED Plus Cohort

ObjectiveTo evaluate the effect of Non-alcoholic fatty liver disease (NAFLD) status in the impact of lifestyle over Health-related quality of life (HRQoL) in patients with metabolic syndrome (MetS). MethodsBaseline and 1 year follow up data from the PREDIMED-plus cohort (men and women, 55-75 years old with overweight/obesity and MetS) were studied. Adherence to an energy-restricted Mediterranean Diet (er-MeDiet) and Physical Activity (PA) were assessed with a validated screeners. Hepatic steatosis index (HSI) was implemented to evaluate NAFLD while the SF-36 questionnaire provided HRQoL evaluation. Statistical analyses were performed to evaluate the influence of baseline NAFLD on HRQoL as affected by lifestyle during 1 year of follow up. ResultsData from 5205 patients with mean age of 65 years and a 48% of female participants. Adjusted linear multivariate mixed regression models showed that patients with lower probability of NAFLD (HSI < 36 points) were more responsive to er-MeDiet (beta 0.64 vs beta 0.05 per er-MeDiet adherence point, p< 0.01) and PA (beta 0.05 vs beta 0.01 per MET-h/week, p = 0.001) than those with high probability for NAFLD in terms Physical SF-36 summary in the 1 year follow up. 10 points of er-MeDiet adherence and 50 MET-h/week were thresholds for a beneficial effect of lifestyle on HRQoL physical domain in patients with lower probability of NAFLD. ConclusionThe evaluation of NAFLD by the HSI index in patients with MetS might identify subjects with different prospective sensitivity to lifestyle changes in terms of physical HRQoL (http://www.isrctn.com/ISRCTN89898870)

Constraints on the χ_(c1) versus χ_(c2) polarizations in proton-proton collisions at √s = 8 TeV

The polarizations of promptly produced χ_(c1) and χ_(c2) mesons are studied using data collected by the CMS experiment at the LHC, in proton-proton collisions at √s=8  TeV. The χ_c states are reconstructed via their radiative decays χ_c → J/ψγ, with the photons being measured through conversions to e⁺e⁻, which allows the two states to be well resolved. The polarizations are measured in the helicity frame, through the analysis of the χ_(c2) to χ_(c1) yield ratio as a function of the polar or azimuthal angle of the positive muon emitted in the J/ψ → μ⁺μ⁻ decay, in three bins of J/ψ transverse momentum. While no differences are seen between the two states in terms of azimuthal decay angle distributions, they are observed to have significantly different polar anisotropies. The measurement favors a scenario where at least one of the two states is strongly polarized along the helicity quantization axis, in agreement with nonrelativistic quantum chromodynamics predictions. This is the first measurement of significantly polarized quarkonia produced at high transverse momentum

Isotemporal substitution of inactive time with physical activity and time in bed: cross-sectional associations with cardiometabolic health in the PREDIMEDPlus study

Background: This study explored the association between inactive time and measures of adiposity, clinical parameters, obesity, type 2 diabetes and metabolic syndrome components. It further examined the impact of reallocating inactive time to time in bed, light physical activity (LPA) or moderate-to-vigorous physical activity (MVPA) on cardio-metabolic risk factors, including measures of adiposity and body composition, biochemical parameters and blood pressure in older adults. Methods: This is a cross-sectional analysis of baseline data from 2189 Caucasian men and women (age 55-75 years, BMI 27-40 Kg/m2) from the PREDIMED-Plus study (http://www.predimedplus.com/). All participants had ≥3 components of the metabolic syndrome. Inactive time, physical activity and time in bed were objectively determined using triaxial accelerometers GENEActiv during 7 days (ActivInsights Ltd., Kimbolton, United Kingdom). Multiple adjusted linear and logistic regression models were used. Isotemporal substitution regression modelling was performed to assess the relationship of replacing the amount of time spent in one activity for another, on each outcome, including measures of adiposity and body composition, biochemical parameters and blood pressure in older adults. Results: Inactive time was associated with indicators of obesity and the metabolic syndrome. Reallocating 30 min per day of inactive time to 30 min per day of time in bed was associated with lower BMI, waist circumference and glycated hemoglobin (HbA1c) (all p-values < 0.05). Reallocating 30 min per day of inactive time with 30 min per day of LPA or MVPA was associated with lower BMI, waist circumference, total fat, visceral adipose tissue, HbA1c, glucose, triglycerides, and higher body muscle mass and HDL cholesterol (all p-values < 0.05). Conclusions: Inactive time was associated with a poor cardio-metabolic profile. Isotemporal substitution of inactive time with MVPA and LPA or time in bed could have beneficial impact on cardio-metabolic health