Hábitos sobre fotoprotección en pacientes de consulta dermatológica

La exposición excesiva al sol constituye una de las causas más comunes de enfermedades cutáneas. El objetivo de la investigación fue describir los hábitos de fotoprotección de pacientes atendidos en la consulta de dermatología del área III de salud, en el municipio Cienfuegos, Cuba, durante el período comprendido entre los meses de enero y mayo de 2020. Se realizó un estudio observacional, descriptivo y transversal, cuya población estuvo constituida por 3045 pacientes, de los que se seleccionó una muestra de 1066 individuos a través de un muestreo no probabilístico por sujetos voluntarios. Los datos fueron recolectados mediante la aplicación de un cuestionario cerrado, el que fue validado por criterio de especialistas. El estudio contó con la aprobación del Comité de Ética de la Investigación de la Universidad de Ciencias Médicas Dr. “Raúl Dorticós Torrado” de Cienfuegos, Cuba. El grupo con más de 59 años resultó el más representado (37,8%), mientras que los menores de 15 años (6,8%) fue el menos. El género femenino prevaleció (53,4%). El cuidado de la piel ante la sobreexposición solar fue insuficiente. Predominaron los que no conocen su tipo de piel y aquellos que no recibieron orientaciones sobre su cuidado. También prevalecieron aquellos cuya declaración indica que nunca realizan autoexamen de este importante órgano y los que no utilizan aditamentos de fotoprotección, específicamente: sombrero, gorra y sombrilla.Excessive sun exposure is one of the most common causes of skin diseases. This research aimed to describe the photoprotection habits of patients treated in the dermatology consultation of health area III, in the municipality of Cienfuegos, Cuba, during the period between the months of January and May 2020. An observational, descriptive, and cross-sectional study was carried out. The population consisted of 3045 patients, from which a sample of 1066 individuals was selected through a non-probabilistic sampling by volunteer subjects. The data were collected by applying a closed questionnaire, which was validated by specialists' criteria. The study was approved by the Research Ethics Committee of the Dr. "Raúl Dorticós Torrado" University of Medical Sciences of Cienfuegos, Cuba. The group over 59 years of age was the most represented (37.8%), while those under 15 years of age (6.8%) were the least. The female gender prevailed (53.4%). Skin care for overexposure to the sun was insufficient. Those ones who do not know their skin type and those who did not receive guidance on their care predominated; as well as those ones whose statement indicates that they never perform self-examination of this important organ and those ones who do not use photoprotection accessories, specifically: hat, cap and umbrella

More, smaller bacteria in response to ocean's warming?

Heterotrophic bacteria play a major role in organic matter cycling in the ocean. Although the high abundances and relatively fast growth rates of coastal surface bacterioplankton make them suitable sentinels of global change, past analyses have largely overlooked this functional group. Here, time series analysis of a decade of monthly observations in temperate Atlantic coastal waters revealed strong seasonal patterns in the abundance, size and biomass of the ubiquitous flow-cytometric groups of low (LNA) and high nucleic acid (HNA) content bacteria. Over this relatively short period, we also found that bacterioplankton cells were significantly smaller, a trend that is consistent with the hypothesized temperature-driven decrease in body size. Although decadal cell shrinking was observed for both groups, it was only LNA cells that were strongly coherent, with ecological theories linking temperature, abundance and individual size on both the seasonal and interannual scale. We explain this finding because, relative to their HNA counterparts, marine LNA bacteria are less diverse, dominated by members of the SAR11 clade. Temperature manipulation experiments in 2012 confirmed a direct effect of warming on bacterial size. Concurrent with rising temperatures in spring, significant decadal trends of increasing standing stocks (3% per year) accompanied by decreasing mean cell size (-1% per year) suggest a major shift in community structure, with a larger contribution of LNA bacteria to total biomass. The increasing prevalence of these typically oligotrophic taxa may severely impact marine food webs and carbon fluxes by an overall decrease in the efficiency of the biological pump.Versión del editor5,064

Discovery of potent and selective inhibitors of the Escherichia coli M1-aminopeptidase via multicomponent solid-phase synthesis of tetrazole-peptidomimetics

The Escherichia coli neutral M1-aminopeptidase (ePepN) is a novel target identified for the development of antimicrobials. Here we describe a solid-phase multicomponent approach which enabled the discovery of potent ePepN inhibitors. The on-resin protocol, developed in the frame of the Distributed Drug Discovery (D3) program, comprises the implementation of parallel Ugi-azide four-component reactions with resin-bound amino acids, thus leading to the rapid preparation of a focused library of tetrazole-peptidomimetics (TPMs) suitable for biological screening. By dose-response studies, three compounds were identified as potent and selective ePepN inhibitors, as little inhibitory effect was exhibited for the porcine ortholog aminopeptidase. The study allowed for the identification of the key structural features required for a high ePepN inhibitory activity. The most potent and selective inhibitor (TPM 11) showed a non-competitive inhibition profile of ePepN. We predicted that both diastereomers of compound TPM 11 bind to a site distinct from that occupied by the substrate. Theoretical models suggested that TPM 11 has an alternative inhibition mechanism that doesn't involve Zn coordination. On the other hand, the activity landscape analysis provided a rationale for our findings. Of note, compound TMP 2 showed in vitro antibacterial activity against Escherichia coli. Furthermore, none of the three identified inhibitors is a potent haemolytic agent, and only two compounds showed moderate cytotoxic activity toward the murine myeloma P3X63Ag cells. These results point to promising compounds for the future development of rationally designed TPMs as antibacterial agents

The prognostic significance of tumor-infiltrating lymphocytes, PD-L1, BRCA mutation status and tumor mutational burden in early-stage high-grade serous ovarian carcinoma. A study by the Spanish Group for Ovarian Cancer Research (GEICO)

Early stages are under-represented in studies on the molecular and immune features of high-grade serous ovarian carcinoma (HGSOC), and specific studies focused on early-stage HGSOC are required for a better prognostic stratification and to personalize chemotherapy. The aim of this study was to determine the prognostic significance of CD8+ and CD4+ tumor-infiltrating lymphocytes (TILs), tumoral cell PD-L1 expression, BRCA mutational status and tumor mutation burden (TMB) in early-stage HGSOC. A retrospective study was performed on stage I and II HGSOC from the Molecular Reclassification of Early Stages of Ovarian Cancer (RECLAMO) cohort from the Spanish Group of Ovarian Cancer Research (GEICO). Centralized histological typing was performed based on morphological and immunohistochemical features. Intraepithelial (i) and stromal (s) CD8+ and CD4+ T cells and PD-L1 were evaluated on tissue microarrays by immunohistochemistry. BRCA1 and BRCA2 mutation status and TMB were analyzed in tumor DNA using next-generation sequencing. The study included 124 tumors. High iCD8+ (>20 TILs/core), low/intermediate CD4+ (35/core) were associated with favorable outcomes. Tumor cell PD-L1 expression (TPS ≥ 1) was present in only 8% of tumors. In total, 11 (16%) and 6 (9%) out of 69 HGSOC tested carried pathogenic or likely pathogenic BRCA1 or BRCA2 mutations, respectively. Median TMB of 40 tumors analyzed was 5.04 mutations/Mb and only 6 tumors had 10 or more mutations/Mb. BRCA status and TMB were not associated with TILs or prognosis. When compared with studies on advanced HGSOC, our results suggested that prognostic variables differed according to stage and that more studies focused on early stages of HGSOC are needed to better stratify these tumors: This work was supported by Instituto de Salud Carlos III (ISCIII) (grants PI19/01331, PI22/01892 and PMP22/00054); CIBERONC (grant CB16/12/00316); European Development Re gional Fund ‘A way to achieve Europe’ (FEDER), Spanish Group of Research in Ovarian Cancer (GEICO group); and by the Spanish Association Against Cancer Scientific Foundation (AECC)

Toenail zinc as a biomarker: Relationship with sources of environmental exposure and with genetic variability in MCC-Spain study

Background: Toenails are commonly used as biomarkers of exposure to zinc (Zn), but there is scarce information about their relationship with sources of exposure to Zn. Objectives: To investigate the main determinants of toenail Zn, including selected sources of environmental exposure to Zn and individual genetic variability in Zn metabolism. Methods: We determined toenail Zn by inductively coupled plasma mass spectrometry in 3,448 general popu-lation controls from the MultiCase-Control study MCC-Spain. We assessed dietary and supplement Zn intake using food frequency questionnaires, residential proximity to Zn-emitting industries and residential topsoil Zn levels through interpolation methods. We constructed a polygenic score of genetic variability based on 81 single nucleotide polymorphisms in genes involved in Zn metabolism. Geometric mean ratios of toenail Zn across categories of each determinant were estimated from multivariate linear regression models on log-transformed toenail Zn. Results: Geometric mean toenail Zn was 104.1 mu g/g in men and 100.3 mu g/g in women. Geometric mean toenail Zn levels were 7 % lower (95 % confidence interval 1-13 %) in men older than 69 years and those in the upper tertile of fibre intake, and 9 % higher (3-16 %) in smoking men. Women residing within 3 km from Zn-emitting industries had 4 % higher geometric mean toenail Zn levels (0-9 %). Dietary Zn intake and polygenic score were unrelated to toenail Zn. Overall, the available determinants only explained 9.3 % of toenail Zn variability in men and 4.8 % in women. Discussion: Sociodemographic factors, lifestyle, diet, and environmental exposure explained little of the indi-vidual variability of toenail Zn in the study population. The available genetic variants related to Zn metabolism were not associated with toenail Zn

Tecnología y aplicaciones de sistemas de software: calidad e innovación en procesos, productos y servicios

El avance de las tecnologías es acompañado por el incremento de los sistemas de software donde la calidad y la innovación toman un lugar esencial tanto en el desarrollo de productos como de servicios. Actualmente al incluir al usuario en los procesos de innovación y ubicarlo en una posición centralizada se da lugar a la aparición de nuevos espacios de interacción y comunicación en los que el actor que consume productos y servicios adquiere un rol activo. Con la premisa de incorporar al usuario en todas las fases del proceso de innovación surgen los Living Labs. Éstos son entornos donde se expone a los usuarios a nuevas aplicaciones, mediante auténticas plataformas de innovación abierta de cocreación y codiseño con los usuarios, para experimentar sobre las implicaciones de una determinada tecnología, como computación ubicua, conectividad móvil, apropiación de las TIC en la educación, el comercio, el gobierno, entre otros, a fin de investigar y analizar, uso, experiencia de usuarios y oportunidades. Nuestro propósito es estudiar cómo se modifican los procesos de desarrollo con la incorporación del usuario final en los procesos de innovación tecnológica desde los siguientes enfoques de investigación: gestión de la innovación, calidad y cómputo ubicuo en gobierno/empresa/ciudades digitales.Eje: Ingeniería de Software.Red de Universidades con Carreras en Informática (RedUNCI

Rationale and design of the Concordance study between FFR and iFR for the assessment of lesions in the left main coronary artery. The ILITRO-EPIC-07 Trial

Introduction and objectives: Patients with left main coronary artery (LMCA) stenosis have been excluded from the trials that support the non-inferiority of the instantaneous wave-free ratio (iFR) compared to the fractional flow reserve (FFR) in the decision-making process of coronary revascularization. This study proposes to prospectively assess the concordance between the two indices in LMCA lesions and to validate the iFR cut-off value of 0.89 for clinical use. Methods: National, prospective, and observational multicenter registry of 300 consecutive patients with intermediate lesions in the LMCA (angiographic stenosis, 25% to 60%. A pressure gudiewire study and determination of the RFF and the iFR will be performed: in the event of a negative concordant result (FFR > 0.80/iFR > 0.89), no treatment will be performed; in case of a positive concordant result (FFR 0.80/iFR 0.89), an intravascular echocardiography will be performed and revascularization will be delayed if the minimum lumen area is > 6 mm(2). The primary clinical endpoint will be a composite of cardiovascular death, LMCA lesion-related non-fatal infarction or need for revascularization of the LMCA lesion at 12 months. Conclusions: Confirm that an iFR-guided decision-making process in patients with intermediate LMCA stenosis is clinically safe and would have a significant clinical impact. Also, justify its systematic use when prescribing treatment in these potentially high-risk patients

Predictive Power of the "Trigger Tool" for the detection of adverse events in general surgery: a multicenter observational validation study

Background In spite of the global implementation of standardized surgical safety checklists and evidence-based practices, general surgery remains associated with a high residual risk of preventable perioperative complications and adverse events. This study was designed to validate the hypothesis that a new “Trigger Tool” represents a sensitive predictor of adverse events in general surgery. Methods An observational multicenter validation study was performed among 31 hospitals in Spain. The previously described “Trigger Tool” based on 40 specific triggers was applied to validate the predictive power of predicting adverse events in the perioperative care of surgical patients. A prediction model was used by means of a binary logistic regression analysis. Results The prevalence of adverse events among a total of 1,132 surgical cases included in this study was 31.53%. The “Trigger Tool” had a sensitivity and specificity of 86.27% and 79.55% respectively for predicting these adverse events. A total of 12 selected triggers of overall 40 triggers were identified for optimizing the predictive power of the “Trigger Tool”. Conclusions The “Trigger Tool” has a high predictive capacity for predicting adverse events in surgical procedures. We recommend a revision of the original 40 triggers to 12 selected triggers to optimize the predictive power of this tool, which will have to be validated in future studies

Exposure to secondhand and thirdhand smoke in private vehicles: Measurements in air and dust samples

Background: This study aimed to estimate airborne nicotine concentrations and nicotine, cotinine, and tobaccospecific nitrosamines (TSNAs) in settled dust from private cars in Spain and the UK. Methods: We measured vapor-phase nicotine concentrations in a convenience sample of 45 private cars from Spain (N = 30) and the UK (N = 15) in 2017-2018. We recruited non-smoking drivers (n = 20), smoking drivers who do not smoke inside the car (n = 15), and smoking drivers who smoke inside (n = 10). Nicotine, cotinine, and three TSNAs (NNK, NNN, NNA) were also measured in settled dust in a random subsample (n = 20). We computed medians and interquartile ranges (IQR) of secondhand smoke (SHS) and thirdhand smoke (THS) compounds according to the drivers' profile. Results: 24-h samples yielded median airborne nicotine concentrations below the limit of quantification (LOQ) (IQR