Tratamientos para las grietas en los pezones durante la lactancia materna: una síntesis de evidencia.

Objective: To describe the current management recommended to health professionals for the treatment of nipple cracks associated with breastfeeding based on scientific evidence. Material and methods: Literature review in different databases such as Pubmed, Embase, Lilacs, among others. Applying filters and selection criteria, 15 articles were obtained in this evidence synthesis. Results: Nipple cracks are generally observed between the third and seventh day after delivery and can continue up to six weeks later, ranking it as the second leading factor in the abandonment of breastfeeding. Regarding the origin, it has been shown that the position and incorrect coupling are considered the most common causes that generate nipple cracks. There is no single method for the prevention or treatment of cracked nipples. Conclusion: A standard treatment for nipple cracks is not recommended, but it will depend on the type of injury. According to the present review and evaluation of the articles, breast milk can be considered effective only if the nipple is red and there is and there is no continuous loss of skin. If this is the case, it is recommended to keep the area clean avoiding moisture to promote tissue healing.Objetivo: Describir el manejo actual recomendado a los profesionales de la salud para el tratamiento de las grietas en el pezón asociadas a la lactancia materna basado en la evidencia científica. Material y métodos: Revisión de la literatura en diferentes bases de datos tales como Pubmed, Embase, Lilacs, entre otras. Aplicando filtros y criterios de selección, se obtuvieron 15 artículos en esta síntesis de evidencia. Resultados: Las grietas del pezón se observan generalmente entre el tercer y el séptimo día después del parto y pueden continuar hasta por seis semanas, posicionándose como el segundo factor de abandono de la lactancia materna. En cuanto al origen, se ha demostrado que la posición y el acople incorrecto se consideran las causas más comunes que generan las grietas del pezón. No existe un único método para la prevención o tratamiento de las grietas en el pezón. Conclusión: No se recomienda un tratamiento estándar para las grietas del pezón, sino que este dependerá del tipo de lesión. De acuerdo a esta revisión y evaluación de los artículos, la leche materna se considerará eficaz solo si el pezón está enrojecido y no hay pérdida de continuidad de la piel, si ese es el caso se recomienda mantener la zona limpia evitando la humedad para favorecer la cicatrización del tejido

Impacts of the Tropical Pacific/Indian Oceans on the Seasonal Cycle of the West African Monsoon

The current consensus is that drought has developed in the Sahel during the second half of the twentieth century as a result of remote effects of oceanic anomalies amplified by local land–atmosphere interactions. This paper focuses on the impacts of oceanic anomalies upon West African climate and specifically aims to identify those from SST anomalies in the Pacific/Indian Oceans during spring and summer seasons, when they were significant. Idealized sensitivity experiments are performed with four atmospheric general circulation models (AGCMs). The prescribed SST patterns used in the AGCMs are based on the leading mode of covariability between SST anomalies over the Pacific/Indian Oceans and summer rainfall over West Africa. The results show that such oceanic anomalies in the Pacific/Indian Ocean lead to a northward shift of an anomalous dry belt from the Gulf of Guinea to the Sahel as the season advances. In the Sahel, the magnitude of rainfall anomalies is comparable to that obtained by other authors using SST anomalies confined to the proximity of the Atlantic Ocean. The mechanism connecting the Pacific/Indian SST anomalies with West African rainfall has a strong seasonal cycle. In spring (May and June), anomalous subsidence develops over both the Maritime Continent and the equatorial Atlantic in response to the enhanced equatorial heating. Precipitation increases over continental West Africa in association with stronger zonal convergence of moisture. In addition, precipitation decreases over the Gulf of Guinea. During the monsoon peak (July and August), the SST anomalies move westward over the equatorial Pacific and the two regions where subsidence occurred earlier in the seasons merge over West Africa. The monsoon weakens and rainfall decreases over the Sahel, especially in August.Peer reviewe

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort

Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors. Conclusion: Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective

Rare predicted loss-of-function variants of type I IFN immunity genes are associated with life-threatening COVID-19

BackgroundWe previously reported that impaired type I IFN activity, due to inborn errors of TLR3- and TLR7-dependent type I interferon (IFN) immunity or to autoantibodies against type I IFN, account for 15-20% of cases of life-threatening COVID-19 in unvaccinated patients. Therefore, the determinants of life-threatening COVID-19 remain to be identified in similar to 80% of cases.MethodsWe report here a genome-wide rare variant burden association analysis in 3269 unvaccinated patients with life-threatening COVID-19, and 1373 unvaccinated SARS-CoV-2-infected individuals without pneumonia. Among the 928 patients tested for autoantibodies against type I IFN, a quarter (234) were positive and were excluded.ResultsNo gene reached genome-wide significance. Under a recessive model, the most significant gene with at-risk variants was TLR7, with an OR of 27.68 (95%CI 1.5-528.7, P=1.1x10(-4)) for biochemically loss-of-function (bLOF) variants. We replicated the enrichment in rare predicted LOF (pLOF) variants at 13 influenza susceptibility loci involved in TLR3-dependent type I IFN immunity (OR=3.70[95%CI 1.3-8.2], P=2.1x10(-4)). This enrichment was further strengthened by (1) adding the recently reported TYK2 and TLR7 COVID-19 loci, particularly under a recessive model (OR=19.65[95%CI 2.1-2635.4], P=3.4x10(-3)), and (2) considering as pLOF branchpoint variants with potentially strong impacts on splicing among the 15 loci (OR=4.40[9%CI 2.3-8.4], P=7.7x10(-8)). Finally, the patients with pLOF/bLOF variants at these 15 loci were significantly younger (mean age [SD]=43.3 [20.3] years) than the other patients (56.0 [17.3] years; P=1.68x10(-5)).ConclusionsRare variants of TLR3- and TLR7-dependent type I IFN immunity genes can underlie life-threatening COVID-19, particularly with recessive inheritance, in patients under 60 years old

First measurement of the top quark pair production cross section in proton-proton collisions at s\sqrt{s} = 13.6 TeV

The first measurement of the top quark pair ($\mathrm{t\bar{t}}$) production cross section in proton-proton collisions at $\sqrt{s}$ = 13.6 TeV is presented. Data recorded with the CMS detector at the CERN LHC in Summer 2022, corresponding to an integrated luminosity of 1.21 fb$^{-1}$, are analyzed. Events are selected with one or two charged leptons (electrons or muons) and additional jets. A maximum likelihood fit is performed in event categories defined by the number and flavors of the leptons, the number of jets, and the number of jets identified as originating from b quarks. An inclusive $\mathrm{t\bar{t}}$ production cross section of 882 $\pm$ 23 (stat+syst) $\pm$ 20 (lumi) pb is measured, in agreement with the standard model prediction of 921$^{+29}_{-37}$ pb

Multiplicity and transverse momentum dependence of charge-balance functions in pPb and PbPb collisions at LHC energies

International audienceMeasurements of the charge-dependent two-particle angular correlation function in proton-lead (pPb) collisions at a nucleon-nucleon center-of-mass energy of $\sqrt{s_\mathrm{NN}}$ = 8.16 TeV and lead-lead (PbPb) collisions at$\sqrt{s_\mathrm{NN}}$ = 5.02 TeV are reported. The pPb and PbPb datasets correspond to integrated luminosities of 186\nbinv and 0.607 nb$^{-1}$, respectively, and were collected using the CMS detector at the CERN LHC. The charge-dependent correlations are characterized by balance functions of same- and opposite-sign particle pairs. The balance functions, which contain information about the creation time of charged particle pairs and the development of collectivity, are studied as functions of relative pseudorapidity ($\Delta \eta$) and relative azimuthal angle ($\Delta \phi$), for various multiplicity and transverse momentum ($p_\mathrm{T}$) intervals. A multiplicity dependence of the balance function is observed in $\Delta \eta$ and $\Delta \phi$ for both systems. The width of the balance functions decreases towards high-multiplicity collisions in the momentum region $\lt$2 GeV, for pPb and PbPb results. No multiplicity dependence is observed at higher transverse momentum. The data are compared with HYDJET, HIJING and AMPT generator predictions, none of which capture completely the multiplicity dependence seen in the data

Multiplicity and transverse momentum dependence of charge-balance functions in pPb and PbPb collisions at LHC energies

International audienceMeasurements of the charge-dependent two-particle angular correlation function in proton-lead (pPb) collisions at a nucleon-nucleon center-of-mass energy of $\sqrt{s_\mathrm{NN}}$ = 8.16 TeV and lead-lead (PbPb) collisions at$\sqrt{s_\mathrm{NN}}$ = 5.02 TeV are reported. The pPb and PbPb datasets correspond to integrated luminosities of 186\nbinv and 0.607 nb$^{-1}$, respectively, and were collected using the CMS detector at the CERN LHC. The charge-dependent correlations are characterized by balance functions of same- and opposite-sign particle pairs. The balance functions, which contain information about the creation time of charged particle pairs and the development of collectivity, are studied as functions of relative pseudorapidity ($\Delta \eta$) and relative azimuthal angle ($\Delta \phi$), for various multiplicity and transverse momentum ($p_\mathrm{T}$) intervals. A multiplicity dependence of the balance function is observed in $\Delta \eta$ and $\Delta \phi$ for both systems. The width of the balance functions decreases towards high-multiplicity collisions in the momentum region $\lt$2 GeV, for pPb and PbPb results. No multiplicity dependence is observed at higher transverse momentum. The data are compared with HYDJET, HIJING and AMPT generator predictions, none of which capture completely the multiplicity dependence seen in the data

Probing small Bjorken-xx nuclear gluonic structure via coherent J/ψ\psi photoproduction in ultraperipheral PbPb collisions at sNN\sqrt{s_\mathrm{NN}} = 5.02 TeV

International audienceQuasi-real photons exchanged in relativistic heavy ion interactions are powerful probes of the gluonic structure of nuclei. The first measurement of the coherent J/$\psi$ photoproduction cross section in ultraperipheral lead-lead collisions is presented over a wide range of photon-nucleus center-of-mass energies per nucleon (W$^\text{Pb}_{\gamma\text{N}}$). Results are obtained using data at the nucleon-nucleon center-of-mass energy of 5.02 TeV collected by the CMS experiment at the CERN LHC, corresponding to an integrated luminosity of 1.52 nb$^{-1}$. The cross section is observed to rise rapidly at low W$^\text{Pb}_{\gamma\text{N}}$, and plateau above W$^\text{Pb}_{\gamma\text{N}}$$\approx$ 40 GeV, up to 400 GeV, a new regime of small Bjorken-$x$ ($\approx$ 6 $\times$ 10$^{-5}$) gluons being probed in a heavy nucleus. The observed energy dependence is not predicted by current quantum chromodynamic models