Apatridia y nacionalidad en América Latina

Esta presentación sobre apatridia y nacionalidad en América Latina, se refiere básicamente a tres aspectos fundamentales, que son: 1) ¿Cuál es el mandato del Alto Comisionado de las Naciones Unidas para los Refugiados (ACNUR) con respecto a la Apatridia?; 2) ¿Cuáles son los estándares regionales para la protección de los apátridas y que ha dicho con respecto a éstos el Sistema Interamericano de protección de derechos humanos; y 3) ¿Dónde estamos con respecto a la ratificación de los instrumentos internacionales a materia de apatridia en este continente

Anatomic relationship of the proximal nail matrix to the extensor hallucis longus tendon insertion

[Abstract] Background The purpose of this study was to delineate the relationship of the terminal extensor hallucis longus tendon insertion to the proximal limit of the nail matrix of the great toe. Material and methods Fifty fresh-frozen human cadaver great toes with no evidence of trauma (average age, 62.5 years; 29 males and 21 females) were used for this study. Under 25X magnification, the proximal limit of the nail matrix and the terminal bony insertion of the extensor hallucis longus tendons were identified. The distance from the terminal tendon insertion to the nail matrix was ascertained using precision calipers, an optical microscope, and autocad® software for windows. Twenty-five great toes were placed in a neutral formalin solution and further analysed by histological longitudinal-sections. The specimens were stained with haematoxylin and eosin and examined microscopically to determine the presence of the extensor hallucis longus tendon along the dorsal aspect of the distal phalanx of each great toe. Results The main result we found in great toes was that the extensor tendon is between the matrix and the phalanx and extends dorsally to the distal aspect of the distal phalanx in all, 100%, specimens. The nail matrix of the great toe is not attached to the periosteum of the dorsal aspect of the base of the distal phalanx as is the case for fingers, because the extensor hallucis tendon is plantar or directly underneath the nail matrix and the tendon is dorsal to the bone. Conclusions We have found that the extensor tendon is between the matrix and the phalanx and extends dorsally to the distal aspect of the distal phalanx. The nail matrix of the great toe is not attached to the periosteum of the dorsal aspect of the base of distal phalanx as is the case in fingers, because the extensor hallucis tendon is plantar or directly underneath the nail matrix and the tendon is dorsal to the bone. Our anatomic study demonstrates that the proximal limit of the matrix and nail bed of the human great toe are dorsal and overlapping the terminal extensor hallucis longus tendon until its distal bony insertion in all specimens

Cultura, subjetividad y problemas de la clínica

Presentamos en esta experiencia de libro en colectivo los esfuerzos de un grupo de intelectuales (psicoanalistas y psicólogos clínicos) con amplia trayectoria en el campo de la docencia universitaria en pregrado y posgrado y también con amplio recorrido en la praxis terapéutica

Epidemiological Algorithm and Early Molecular Testing to Prevent COVID-19 Outbreaks in a Mexican Oncologic Center

Introduction: Prevention strategies and detection of latent COVID-19 infections in oncology staff and oncologic patients are essential to prevent outbreaks in a cancer center. In this study, we used two statistical predictive models in oncology staff and patients from the radiotherapy area to prevent outbreaks and detect COVID-19 cases. Methods: Staff and patients answered a questionnaire (electronic and paper surveys, respectively) with clinical and epidemiological information. The data was collected through two online survey tools: Real-Time Tracking (R-Track) and Summary of Factors (S-Facts). According to the algorithm\u27s models, cut-off values were established. SARS-CoV-2 qRT-PCR tests confirmed the algorithm\u27s positive individuals. Results: Oncology staff members (n=142) were tested, and 14% (n=20) were positives for the R-Track algorithm; 75% (n=15) were qRT-PCR positive. The S-Facts algorithm identified 7.75% (n=11) positive oncology staff members, and 81.82% (n=9) were qRT-PCR positive. Oncology patients (n=369) were evaluated, and 1.36% (n=5) were positive for the algorithms. The 5 patients (100%) were confirmed by qRT-PCR at a very early stage. Conclusions: The proposed algorithms could prove to become an essential prevention tool in countries where qRT-PCR tests and vaccines are insufficient for the population

How does a cadaver model work for testing ultrasound diagnostic capability for rheumatic-like tendon damage?

To establish whether a cadaver model can serve as an effective surrogate for the detection of tendon damage characteristic of rheumatoid arthritis (RA). In addition, we evaluated intraobserver and interobserver agreement in the grading of RA-like tendon tears shown by US, as well as the concordance between the US findings and the surgically induced lesions in the cadaver model. RA-like tendon damage was surgically induced in the tibialis anterior tendon (TAT) and tibialis posterior tendon (TPT) of ten ankle/foot fresh-frozen cadaveric specimens. Of the 20 tendons examined, six were randomly assigned a surgically induced partial tear; six a complete tear; and eight left undamaged. Three rheumatologists, experts in musculoskeletal US, assessed from 1 to 5 the quality of US imaging of the cadaveric models on a Likert scale. Tendons were then categorized as having either no damage, (0); partial tear, (1); or complete tear (2). All 20 tendons were blindly and independently evaluated twice, over two rounds, by each of the three observers. Overall, technical performance was satisfactory for all items in the two rounds (all values over 2.9 in a Likert scale 1-5). Intraobserver and interobserver agreement for US grading of tendon damage was good (mean κ values 0.62 and 0.71, respectively), with greater reliability found in the TAT than the TPT. Concordance between US findings and experimental tendon lesions was acceptable (70-100 %), again greater for the TAT than for the TPT. A cadaver model with surgically created tendon damage can be useful in evaluating US metric properties of RA tendon lesions

Relationship of runoff, erosion and sediment yield to weather types in the Iberian Peninsula

Precipitation has been recognized as one of the main factors driving soil erosion and sediment yield (SY), and its spatial and temporal variability is recognized as one of themain reasons for spatial and temporal analyses of soil erosion variability. The weather types (WTs) approach classifies the continuumof atmospheric circulation into a small number of categories or types and has been proven a good indicator of the spatial and temporal variability of precipitation. Thus, themain objective of this study is to analyze the relationship betweenWTs, runoff, soil erosion (measured in plots), and sediment yield (measured in catchments) in different areas of the Iberian Peninsula (IP) with the aimof detecting spatial variations in these relationships. To this end, hydrological and sediment information covering the IP from several Spanish research teams has been combined, and related with daily WTs estimated by using the NMC/NCAR 40-Year Reanalysis Project. The results showthat, in general, a fewWTs (particularly westerly, southwesterly and cyclonic) provide the largest amounts of precipitation; and southwesterly, northwesterly and westerly WTs play an important role in runoff generation, erosion and sediment yield as they coincide with the wettest WTs. However, this study highlights the spatial variability of erosion and sediment yield in the IP according to WT, differentiating (1) areas under the influence of north and/or north-westerly flows (the north coast of Cantabria and inland central areas), (2) areas under the influence of westerly, southwesterly and cyclonic WTs (western and southwestern IP), (3) areas in which erosion and sediment yield are controlled by easterly flows (Mediterranean coastland), and (4) lastly, a transitional zone in the inland northeast Ebro catchment,wherewe detected a high variability in the effects ofWTs on erosion. Overall results suggest that the use of WTs derived fromobserved atmospheric pressure patterns could be a useful tool for inclusion in future projections of the spatial variability of erosion and sediment yield, as models capture pressure fields reliably

Investigación clinicoepidemiológica en envejecimiento: metodología del proyecto encuesta salud, bienestar y envejecimiento (SABE) en México

La población de personas adultas mayores crece de forma paulatina y sostenida en el mundo y por ende en nuestro país. Sin embargo, la información que se tiene sobre la forma de vida, salud y bienestar de este grupo poblacional es limitada debido a que la mayor parte de las investigaciones en adultos mayores es derivada del estudio de grupos pequeños con patología bien circunscrita y características especiales. Por otro lado, la realización de estudios, en la población abierta, que permitan establecer la demografía y epidemiología de las personas mayores de 60 años requieren de una gran infraestructura y recursos tanto humanos como económicos. El Proyecto-Encuesta Salud Bienestar y Envejecimiento (SABE), mediante la realización de un estudio tipo encuesta, tiene la finalidad de obtener dicha información contando conla participación del Sector Salud, instituciones de educación superior así como organizaciones no gubernamentales lo que constituye un logro interinstitucional. Para la realización del proyecto SABE se ha seguido con rigurosidad científica el protocolo y para su puesta en marcha hubo la necesidad de la integración intersectorial de las instituciones que brindan atención a los adultos mayores mexicanos, ya sea dentro del contexto de la seguridad o asistencia social. Los alcances de SABE permitirán la creación y difusión del conocimiento derivado del mismo. En este documento, se expone y analiza de forma breve y concreta la metodología operativa de SABE México, lo que significa dar el primer paso para que otros investigadores interesados en el tema, realicen este tipo de estudios. Dada la experiencia que se ha ido generando en la realización de SABE México, este tipo de documentos sirven como base para proponer e iniciar las acciones al respecto.&nbsp

Towards precision medicine: defining and characterizing adipose tissue dysfunction to identify early immunometabolic risk in symptom-free adults from the GEMM family study

Interactions between macrophages and adipocytes are early molecular factors influencing adipose tissue (AT) dysfunction, resulting in high leptin, low adiponectin circulating levels and low-grade metaflammation, leading to insulin resistance (IR) with increased cardiovascular risk. We report the characterization of AT dysfunction through measurements of the adiponectin/leptin ratio (ALR), the adipo-insulin resistance index (Adipo-IRi), fasting/postprandial (F/P) immunometabolic phenotyping and direct F/P differential gene expression in AT biopsies obtained from symptom-free adults from the GEMM family study. AT dysfunction was evaluated through associations of the ALR with F/P insulin-glucose axis, lipid-lipoprotein metabolism, and inflammatory markers. A relevant pattern of negative associations between decreased ALR and markers of systemic low-grade metaflammation, HOMA, and postprandial cardiovascular risk hyperinsulinemic, triglyceride and GLP-1 curves was found. We also analysed their plasma non-coding microRNAs and shotgun lipidomics profiles finding trends that may reflect a pattern of adipose tissue dysfunction in the fed and fasted state. Direct gene differential expression data showed initial patterns of AT molecular signatures of key immunometabolic genes involved in AT expansion, angiogenic remodelling and immune cell migration. These data reinforce the central, early role of AT dysfunction at the molecular and systemic level in the pathogenesis of IR and immunometabolic disorders

The Bacterial Mucosal Immunotherapy MV130 Protects Against SARS-CoV-2 Infection and Improves COVID-19 Vaccines Immunogenicity

COVID-19-specific vaccines are efficient prophylactic weapons against SARS-CoV-2 virus. However, boosting innate responses may represent an innovative way to immediately fight future emerging viral infections or boost vaccines. MV130 is a mucosal immunotherapy, based on a mixture of whole heat-inactivated bacteria, that has shown clinical efficacy against recurrent viral respiratory infections. Herein, we show that the prophylactic intranasal administration of this immunotherapy confers heterologous protection against SARS-CoV-2 infection in susceptible K18-hACE2 mice. Furthermore, in C57BL/6 mice, prophylactic administration of MV130 improves the immunogenicity of two different COVID-19 vaccine formulations targeting the SARS-CoV-2 spike (S) protein, inoculated either intramuscularly or intranasally. Independently of the vaccine candidate and vaccination route used, intranasal prophylaxis with MV130 boosted S-specific responses, including CD8+-T cell activation and the production of S-specific mucosal IgA antibodies. Therefore, the bacterial mucosal immunotherapy MV130 protects against SARS-CoV-2 infection and improves COVID-19 vaccines immunogenicity.CF was supported by AECC Foundation (INVES192DELF) and is currently funded by the Miguel Servet program (ID: CP20/00106) (ISCIII). IH-M receives the support of a fellowship from la Caixa Foundation (ID 100010434, fellowship code: LCF/BQ/IN17/11620074) and from the European Union’s Horizon 2020 research and innovation program under the Marie Skłodowska-Curie grant agreement no. 713673. AJ-C is a postgraduate fellow of the City Council of Madrid at the Residencia de Estudiantes (2020–2021). GD is supported by an European Molecular Biology Organization (EMBO) Long-term fellowship (ALTF 379-2019). This project has received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No. Project number 892965. OL and JA-C acknowledge Comunidad de Madrid (Tec4Bio-CM, S2018/NMT-4443, FEDER). Work in OL laboratory was funded by CNIO with the support of the projects Y2018/BIO4747 and P2018/NMT4443 from Comunidad de Madrid and co-funded by the European Social Fund and the European Regional Development Fund. The CNIO is supported by the Instituto de Salud Carlos III (ISCIII). Work at CNB and CISA is funded by the Spanish Health Ministry, Instituto de Salud Carlos III (ISCIII), Fondo COVID-19 grant COV20/00151, and Fondo Supera COVID-19 (Crue Universidades-Banco Santander) (to JG-A). Work in the DS laboratory is funded by the CNIC; by the European Research Council (ERC-2016-Consolidator Grant 725091); by Agencia Estatal de Investigación (PID2019-108157RB); by Comunidad de Madrid (B2017/BMD-3733 Immunothercan-CM); by Fondo Solidario Juntos (Banco Santander); by a research agreement with Inmunotek S.L.; and by Fundació La Marató de TV3 (201723). The CNIC is supported by the Instituto de Salud Carlos III (ISCIII), the MICINN, and the Pro CNIC Foundation.Peer reviewe