Consideraciones para la provisión de servicios de regulación de fertilidad para mujeres durante la pandemia por COVID-19

Introduction. The sexual and reproductive health (SRH) constitutes a universal human right. Due the consequences generated by the pandemic Virus SARS-COV-2 sexual and reproductive health benefits have been deprioritized in different countries. In Chile, a loss in access and continuity of benefits has been observed due to the reorientation of primary health care resources. The consequences of these decisions affected the preventive benefits in SRH and the discontinuation of contraceptive controls. The latter becomes more serious if it is observed that this level solves 95 % of the contraceptive benefits of the entire public network. Objectives. Describe the main international recommendations available regarding the management of contraception in pandemic times and generate proposals for our country. Material and Methods. It was done a literature review in Pubmed, the Cochrane Library and the websites of the main international Spanish and English-speaking scientific societies. Results. 6 documents were identified that systematize the recent and updated information so that the countries can face better the problems in contraception. The results were organized into the following categories: implementation of a non-face-to-face consultation system, suggestions for access to information / services and management of different types of contraception. Conclusions. The adoption of all or some of the proposed measures implies that the health system can prevent the consequences derived from the loss of access and continuity in contraceptive and SRH services.Introducción. La salud sexual y reproductiva (SSR) constituye un derecho humano universal. Debido a las consecuencias generadas por la pandemia del Virus SARS-COV-2 las prestaciones en salud sexual y reproductiva han sido postergadas en diferentes países. En Chile, debido a las medidas de distanciamiento social y reorganización de los servicios, se ha observado una pérdida en el acceso y continuidad de las prestaciones a causa de la reorientación de los recursos de atención primaria de salud. Las consecuencias de estas decisiones afectan a las prestaciones preventivas en SSR y descontinuación de los controles de anticoncepción. Esto último se torna más grave si se observa que este nivel resuelve el 95 % de las prestaciones de anticoncepción de toda la red pública. Objetivos. Describir las principales recomendaciones internacionales disponibles respecto del manejo de la anticoncepción en tiempos de pandemia y generar propuestas generales aplicables a nuestro país. Material y métodos. Se realizó una revisión de literatura en Pubmed, Biblioteca Cochrane y sitios web de las principales sociedades científicas internacionales de habla hispana e inglesa. Resultados. Se identificaron 6 documentos que sistematizan la información reciente y actualizada para que los países puedan enfrentar de la mejor manera las problemáticas en anticoncepción. Los resultados fueron organizados en: implementación de sistema de consultas no presenciales, sugerencias para el acceso a información/ servicios y manejo de los distintos tipos de anticoncepción. Conclusiones. La adopción de la totalidad o algunas de las medidas propuestas supone que un sistema de salud pueda prevenir las consecuencias derivadas de la pérdida de acceso y continuidad en los servicios de anticoncepción y SSR

Effects of Plyometric Training on Explosive and Endurance Performance at Sea Level and at High Altitude

Plyometric training performed at sea level enhance explosive and endurance performance at sea level. However, its effects on explosive and endurance performance at high altitude had not been studied. Therefore, the aim of this study was to determine the effects of a sea level short-term (i.e., 4-week) plyometric training program on explosive and endurance performance at sea level and at high altitude (i.e., 3,270 m above sea level). Participants were randomly assigned to a control group (n = 12) and a plyometric training group (n = 11). Neuromuscular (reactive strength index – RSI) and endurance (2-km time-trial; running economy [RE]; maximal oxygen uptake - VO2max) measurements were performed at sea level before, at sea level after intervention (SL +4 week), and at high altitude 24-h post SL +4 week. The ANOVA revealed that at SL +4 week the VO2max was not significantly changed in any group, although RE, RSI and 2-km time trial were significantly (p < 0.05) improved in the plyometric training group. After training, when both groups were exposed to high altitude, participants from the plyometric training group showed a greater RSI (p < 0.05) and were able to maintain their 2-km time trial (11.3 ± 0.5 min vs. 10.7 ± 0.6 min) compared to their pre-training sea level performance. In contrast, the control group showed no improvement in RSI, with a worse 2-km time trial performance (10.3 ± 0.8 min vs. 9.02 ± 0.64 min; p < 0.05; ES = 0.13). Moreover, after training, both at sea level and at high altitude the plyometric training group demonstrated a greater (p < 0.05) RSI and 2-km time trial performance compared to the control group. The oxygen saturation was significantly decreased after acute exposure to high altitude in the two groups (p < 0.05). These results confirm the beneficial effects of sea level short-term plyometric training on explosive and endurance performance at sea level. Moreover, current results indicates that plyometric training may also be of value for endurance athletes performing after an acute exposure to high altitude

Giant cell arteritis and its mimics: A comparison of three patient cohorts

Objective: To compare temporal artery biopsy (TAB)-positive giant cell arteritis (GCA) to TAB-negative GCA and patients with GCA mimicsMethods: Patients diagnosed with TAB-positive and TAB-negative GCA between 1/1/1998 and 12/31/2013 were: retrospectively identified. These two groups were compared to a cohort of patients with TAB performed between 1/1/2009 and 12/31/2010 in which the TAB was negative and alternative diagnosis was provided after a minimum of 6-months of follow-up. Baseline characteristics were compared between groups using chi-square and rank sum tests.Results: 591 study subjects were identified (286 TAB-positive, 110 TAB-negative GCA and 195 TAB-negative GCA mimics) during the respective study periods. Compared to TAB-negative GCA, GCA mimics had similar rates of headache and vision loss but significantly less frequent jaw/limb claudication, arterial bruits and constitutional symptoms, as well as lower platelet levels. Compared to TAB-positive GCA patients, TAB-negative GCA were younger, had shorter time to diagnosis, met fewer 1990 ACR classification criteria and had lower frequencies of polymyalgia rheumatica, jaw claudication and temporal artery abnormalities; but, higher frequency of arm claudication and constitutional symptoms. Among 61 TAB-negative patients with advanced arterial imaging, 43 (69%) had at least one abnormality consistent with GCA.Conclusion: Consideration of alternative diagnoses is requisite in evaluating patients with negative TAB. Advanced imaging assists in identifying occult large-vessel vasculitis and should be employed in all TAB-negative patients with suspicion for GCA. (C) 2020 Elsevier Inc. All rights reserved

Efficacy of Methotrexate in Real-world Management of Giant Cell Arteritis: A Case-control Study

To determine the effect of methotrexate (MTX) on relapse risk and glucocorticoid (GC) use in a large single-institution cohort of patients with giant cell arteritis (GCA)

Effects of general, specific and combined warm-up on explosive muscular performance

The purpose of this study was to compare the acute effects of general, specific and combined warm-up (WU) on explosive performance. Healthy male (n=10) subjects participated in six WU protocols in a crossover randomized study design. Protocols were: passive rest (PR; 15 min of passive rest), running (Run; 5 min of running at 70% of maximum heart rate), stretching (STR; 5 min of static stretching exercise), jumping [Jump; 5 min of jumping exercises – 3x8 countermovement jumps (CMJ) and 3x8 drop jumps from 60 cm (DJ60)], and combined (COM; protocols Run + STR + Jump combined). Immediately before and after each WU, subjects were assessed for explosive concentric-only (i.e. squat jump – SJ), slow stretch-shortening cycle (i.e. CMJ), fast stretch-shortening cycle (i.e. DJ60) and contact time (CT) muscle performance. PR significantly reduced SJ performance (p =0.007). Run increased SJ (p =0.0001) and CMJ (p =0.002). STR increased CMJ (p =0.048). Specific WU (i.e. Jump) increased SJ (p =0.001), CMJ (p =0.028) and DJ60 (p =0.006) performance. COM increased CMJ performance (p =0.006). Jump was superior in SJ performance vs. PR (p =0.001). Jump reduced (p =0.03) CT in DJ60. In conclusion, general, specific and combined WU increase slow stretch-shortening cycle (SSC) muscle performance, but only specific WU increases fast SSC muscle performance. Therefore, to increase fast SSC performance, specific fast SSC muscle actions must be included during the WU

Arsenic trioxide-increased MDCK cells proliferation requires activator protein 1-mediated increase of the sodium/proton exchanger 1 activity

The release of protons (H) occurs via the Na/H exchanger isoform 1 (NHE1) leading to a stable intracellular pH (pHi) in MDCK cells. Chronic intake of arsenic trioxide (ATO), in the drinking water, associated with higher morbidity and mortality in neoplastic tissues. ATO increased NHE1 expression and activity, resulting in intracellular alkalization and higher MDCK cells proliferation. Since the pro-proliferative transcription factor activator protein 1 (AP-1) gets activated by al alkaline intracellular pH, a phenomenon paralleled by higher NHEs activity, we asked whether ATO-increased MDCK cells proliferation involves AP-1–dependent NHE1 activation. Cells were exposed (48 h) to ATO (0.05 μmol/L), SR11302 (1 μmol/L, AP-1 inhibitor), HOE-694 (100 nmol/L, NHE1 inhibitor) and EIPA (50 μmol/L, NHE1/NHE3 inhibitor) in the presence of S3226 (10 μmol/L, NHE3 inhibitor), concanamycin A (0.1 μmol/L, V-ATPases inhibitor), and Schering (10 μmol/L, H/K-ATPase inhibitor). [H]Thymidine incorporation, cell counting, wound healing assay, and AP-1 activity were determined. The pHi was measured in cells pre-loaded (10 min) with 2,7-bicarboxyethyl-5,6-carboxyfluorescein acetoxymethyl ester (12 mmol/L) and exposed to NHCl (20 mmol/L). Basal pHi and recovery rate (dpHi/dt), intracellular buffer capacity (βi) and H flux (J) were determined. NHE1 protein abundance was measured by Western blotting and immunofluorescence. ATO increased the cell growth (1.5 fold), basal pHi (0.4 pHi units), dpHi/dt (1.8 fold), J (1.4 fold), AP-1 activity and NHE1 protein abundance (1.3 fold). ATO also increased (1.5 fold) the nuclear/perinuclear NHE1 immunosignal. SR11302 and HOE-694 blocked ATO effects. Thus, ATO-increased proliferation resulted from AP-1–dependent NHE1 activation in MDCK cells

Clinical and pulmonary function analysis in long-COVID revealed that long-term pulmonary dysfunction is associated with vascular inflammation pathways and metabolic syndrome

IntroductionLong-term pulmonary dysfunction (L-TPD) is one of the most critical manifestations of long-COVID. This lung affection has been associated with disease severity during the acute phase and the presence of previous comorbidities, however, the clinical manifestations, the concomitant consequences and the molecular pathways supporting this clinical condition remain unknown. The aim of this study was to identify and characterize L-TPD in patients with long-COVID and elucidate the main pathways and long-term consequences attributed to this condition by analyzing clinical parameters and functional tests supported by machine learning and serum proteome profiling.MethodsPatients with L-TPD were classified according to the results of their computer-tomography (CT) scan and diffusing capacity of the lungs for carbon monoxide adjusted for hemoglobin (DLCOc) tests at 4 and 12-months post-infection.ResultsRegarding the acute phase, our data showed that L-TPD was favored in elderly patients with hypertension or insulin resistance, supported by pathways associated with vascular inflammation and chemotaxis of phagocytes, according to computer proteomics. Then, at 4-months post-infection, clinical and functional tests revealed that L-TPD patients exhibited a restrictive lung condition, impaired aerobic capacity and reduced muscular strength. At this time point, high circulating levels of platelets and CXCL9, and an inhibited FCgamma-receptor-mediated-phagocytosis due to reduced FcγRIII (CD16) expression in CD14+ monocytes was observed in patients with L-TPD. Finally, 1-year post infection, patients with L-TPD worsened metabolic syndrome and augmented body mass index in comparison with other patient groups.DiscussionOverall, our data demonstrated that CT scan and DLCOc identified patients with L-TPD after COVID-19. This condition was associated with vascular inflammation and impair phagocytosis of virus-antibody immune complexes by reduced FcγRIII expression. In addition, we conclude that COVID-19 survivors required a personalized follow-up and adequate intervention to reduce long-term sequelae and the appearance of further metabolic diseases

The STRIP instrument of the Large Scale Polarization Explorer:Microwave eyes to map the Galactic polarized foregrounds

\u3cp\u3eIn this paper we discuss the latest developments of the STRIP instrument of the Large Scale Polarization Explorer (LSPE) experiment. LSPE is a novel project that combines ground-based (STRIP) and balloon-borne (SWIPE) polarization measurements of the microwave sky on large angular scales to attempt a detection of the B-modes of the Cosmic Microwave Background polarization. STRIP will observe approximately 25% of the Northern sky from the Observatorio del Teide in Tenerife, using an array of forty-nine coherent polarimeters at 43 GHz, coupled to a 1.5 m fully rotating crossed-Dragone telescope. A second frequency channel with six-elements at 95 GHz will be exploited as an atmospheric monitor. At present, most of the hardware of the STRIP instrument has been developed and tested at sub-system level. System-level characterization, starting in July 2018, will lead STRIP to be shipped and installed at the observation site within the end of the year. The on-site verification and calibration of the whole instrument will prepare STRIP for a 2-years campaign for the observation of the CMB polarization.\u3c/p\u3