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Advances in melanoma research have unveiled critical insights into its genetic and molecular landscape, leading to significant therapeutic innovations. This review explores the intricate interplay between genetic alterations, such as mutations in BRAF, NRAS, and KIT, and melanoma pathogenesis. The MAPK and PI3K/Akt/mTOR signaling pathways are highlighted for their roles in tumor growth and resistance mechanisms. Additionally, this review delves into the impact of epigenetic modifications, including DNA methylation and histone changes, on melanoma progression. The tumor microenvironment, characterized by immune cells, stromal cells, and soluble factors, plays a pivotal role in modulating tumor behavior and treatment responses. Emerging technologies like single-cell sequencing, CRISPR-Cas9, and AI-driven diagnostics are transforming melanoma research, offering precise and personalized approaches to treatment. Immunotherapy, particularly immune checkpoint inhibitors and personalized mRNA vaccines, has revolutionized melanoma therapy by enhancing the body's immune response. Despite these advances, resistance mechanisms remain a challenge, underscoring the need for combined therapies and ongoing research to achieve durable therapeutic responses. This comprehensive overview aims to highlight the current state of melanoma research and the transformative impacts of these advancements on clinical practice.

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La gingivitis se ha definido como una inflamación de la encía caracterizada por edema, eritema, cambio de la morfología normal, exudado acuoso y hemorragia de interés mundial. El objetivo fue evaluar el efecto dos pastas dentales en pacientes jóvenes diagnosticados con gingivitis en la ciudad de CuscoPerú en el año 2022. La investigación se realizó en alumnos de la Facultad de Economía de la Universidad Nacional San Antonio Abad del Cusco todos ellos diagnosticados con gingivitis en el mismo año. El estudio se desarrolló bajo un diseño experimental pre-test post-test con dos grupos experimentales cada uno con n=15. Evaluados con el índice de placa de Löe & Silness y el índice gingival de Löe & Silness (IG). Los participantes fueron orientados a cepillar los dientes con el dentífrico tres veces al día, por un periodo de 2 semanas. Se utilizó como instrumento de recolección de datos una matriz de registro para la medición antes y después de aplicado el tratamiento en la cual se plasmaron los índices de placa e índice gingival de Löe & Silness. Resultó que los sujetos del estudio en su gran mayoría presentaron gingivitis moderada y un estado de higiene oral regular. Con lo cual concluimos que la pasta dental aplicada en el Grupo I resultó más efectiva en la recuperación de pacientes con gingivitis. El dentífrico con contenido de Ratania fue bien tolerado por los participantes, no existiendo ningún tipo de alteración de tipo alérgica en los tejidos bucales, por lo tanto, no interrumpió el tratamiento.

Gingivitis has been defined as an inflammation of the gum characterized by edema, erythema, change in normal morphology, watery exudate, and bleeding of global interest. The aim was to evaluate the effect of two toothpastes on young patients diagnosed with gingivitis in the city of Cusco, Peru in 2022. The research was conducted on students from the Faculty of Economics at the National University of San Antonio Abad in Cusco, all diagnosed with gingivitis in the same year. The study was carried out under a pre-test post-test experimental design with two experimental groups, each with n=15. Evaluated using the Löe & Silness plaque index and the Löe & Silness gingival index (GI). Participants were instructed to brush their teeth with the toothpaste three times a day for a period of 2 weeks. A data collection instrument was used, a record matrix for measurement before and after treatment application, where the Löe & Silness plaque and gingival indices were recorded. The study subjects mostly presented moderate gingivitis and a regular oral hygiene status. Therefore, we conclude that the toothpaste applied in Group I was more effective in the recovery of patients with gingivitis. The toothpaste containing Ratania was well tolerated by the participants, with no allergic tissue alterations in the oral tissues, thus not interrupting the treatment.

A gengivite foi definida como uma inflamação da gengiva caracterizada por edema, eritema, alteração na morfologia normal, exsudato aquoso e sangramento de interesse mundial. O objetivo foi avaliar o efeito de duas pastas de dentes em pacientes jovens diagnosticados com gengivite na cidade de Cusco, Peru, em 2022. A pesquisa foi realizada em alunos da Faculdade de Economia da Universidade Nacional de San Antonio Abad em Cusco, todos diagnosticados com gengivite no mesmo ano. O estudo foi realizado sob um desenho experimental pré-teste pós-teste com dois grupos experimentais, cada um com n=15. Avaliados com o índice de placa de Löe & Silness e o índice gengival de Löe & Silness (IG). Os participantes foram orientados a escovar os dentes com a pasta de dentes três vezes ao dia, por um período de 2 semanas. Foi utilizado como instrumento de coleta de dados uma matriz de registro para medição antes e depois da aplicação do tratamento, na qual foram registrados os índices de placa e índice gengival de Löe & Silness. A maioria dos sujeitos do estudo apresentou gengivite moderada e um estado de higiene oral regular. Portanto, concluímos que a pasta de dentes aplicada no Grupo I foi mais eficaz na recuperação de pacientes com gengivite. A pasta de dentes com conteúdo de Ratania foi bem tolerada pelos participantes, não havendo nenhuma alteração alérgica nos tecidos bucais, portanto, não interrompendo o tratamento.

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La gingivitis se ha definido como una inflamación de la encía caracterizada por edema, eritema, cambio de la morfología normal, exudado acuoso y hemorragia de interés mundial. El objetivo fue evaluar el efecto dos pastas dentales en pacientes jóvenes diagnosticados con gingivitis en la ciudad de Cusco-Perú en el año 2022. La investigación se realizó en alumnos de la Facultad de Economía de la Universidad Nacional San Antonio Abad del Cusco todos ellos diagnosticados con gingivitis en el mismo año. El estudio se desarrolló bajo un diseño experimental pre-test post-test con dos grupos experimentales cada uno con n=15. Evaluados con el índice de placa de Löe & Silness y el índice gingival de Löe & Silness (IG). Los participantes fueron orientados a cepillar los dientes con el dentífrico tres veces al día, por un periodo de 2 semanas. Se utilizó como instrumento de recolección de datos una matriz de registro para la medición antes y después de aplicado el tratamiento en la cual se plasmaron los índices de placa e índice gingival de Löe & Silness. Resultó que los sujetos del estudio en su gran mayoría presentaron gingivitis moderada y un estado de higiene oral regular. Con lo cual concluimos que la pasta dental aplicada en el Grupo I resultó más efectiva en la recuperación de pacientes con gingivitis. El dentífrico con contenido de Ratania fue bien tolerado por los participantes, no existiendo ningún tipo de alteración de tipo alérgica en los tejidos bucales, por lo tanto, no interrumpió el tratamiento.

Gingivitis has been defined as an inflammation of the gum characterized by edema, erythema, change in normal morphology, watery exudate, and bleeding of global interest. The aim was to evaluate the effect of two toothpastes on young patients diagnosed with gingivitis in the city of Cusco, Peru in 2022. The research was conducted on students from the Faculty of Economics at the National University of San Antonio Abad in Cusco, all diagnosed with gingivitis in the same year. The study was carried out under a pre-test post-test experimental design with two experimental groups, each with n=15. Evaluated using the Löe & Silness plaque index and the Löe & Silness gingival index (GI). Participants were instructed to brush their teeth with the toothpaste three times a day for a period of 2 weeks. A data collection instrument was used, a record matrix for measurement before and after treatment application, where the Löe & Silness plaque and gingival indices were recorded. The study subjects mostly presented moderate gingivitis and a regular oral hygiene status. Therefore, we conclude that the toothpaste applied in Group I was more effective in the recovery of patients with gingivitis. The toothpaste containing Ratania was well tolerated by the participants, with no allergic tissue alterations in the oral tissues, thus not interrupting the treatment.

A gengivite foi definida como uma inflamação da gengiva caracterizada por edema, eritema, alteração na morfologia normal, exsudato aquoso e sangramento de interesse mundial. O objetivo foi avaliar o efeito de duas pastas de dentes em pacientes jovens diagnosticados com gengivite na cidade de Cusco, Peru, em 2022. A pesquisa foi realizada em alunos da Faculdade de Economia da Universidade Nacional de San Antonio Abad em Cusco, todos diagnosticados com gengivite no mesmo ano. O estudo foi realizado sob um desenho experimental pré-teste pós-teste com dois grupos experimentais, cada um com n=15. Avaliados com o índice de placa de Löe & Silness e o índice gengival de Löe & Silness (IG). Os participantes foram orientados a escovar os dentes com a pasta de dentes três vezes ao dia, por um período de 2 semanas. Foi utilizado como instrumento de coleta de dados uma matriz de registro para medição antes e depois da aplicação do tratamento, na qual foram registrados os índices de placa e índice gengival de Löe & Silness. A maioria dos sujeitos do estudo apresentou gengivite moderada e um estado de higiene oral regular. Portanto, concluímos que a pasta de dentes aplicada no Grupo I foi mais eficaz na recuperação de pacientes com gengivite. A pasta de dentes com conteúdo de Ratania foi bem tolerada pelos participantes, não havendo nenhuma alteração alérgica nos tecidos bucais, portanto, não interrompendo o tratamento.

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A major concern for wineries is haze formation in white wines due to protein instability. Despite its prevalent use, the conventional bentonite method has shortcomings, including potential alteration of color and aroma, slow processing times, and notable wine wastage. Zirconium oxide (ZrO2) effectively removes proteins without affecting wine characteristics. However, producing cost-effective ZrO2 materials with efficient protein removal capabilities poses a significant challenge. This research aims to assess the viability of designing a porous material impregnated with zirconia to remove turbidity-causing proteins effectively. For this purpose, the support material alone (Al2O3) and the zirconia-impregnated support (ZrO2/Al2O3) were subjected to different calcination temperatures. It was observed that high-temperature treatments (750 °C) enhanced wine stability and protein adsorption capacity. The optimal adsorbent achieved a notable reduction in turbidity, decreasing the ΔNTU from 42 to 18, alongside a significant 44 % reduction in the total protein content, particularly affecting proteins in the molecular weight range of 10 to 70 kDa. This result is attributed to modifying the textural properties of ZrO2/Al2O3, characterized by the reduction of acidic sites, augmented pore diameters from 4.81 to 7.74 nm, and the emergence of zirconia clusters across the surface of the porous support. In summary, this study presents the first application of zirconia on the alumina support surface for protein stabilization in white wine. Combining ZrO2/Al2O3 and a high-temperature treatment emerges as a promising, cost-efficient, and environmentally sustainable strategy for protein removal in white wine.

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In the department of Boyacá, Colombia, agriculture stands as one of the primary economic activities. However, the escalating utilization of pesticides within this sector has sparked concern regarding its potential correlation with elevated risks of genotoxicity, chromosomal alterations, and carcinogenesis. Furthermore, pesticides have been associated with a broad spectrum of genetic polymorphisms that impact pivotal genes involved in pesticide metabolism and DNA repair, among other processes. Nonetheless, our understanding of the genotoxic effects of pesticides on the chromosomes (as biomarkers of effect) in exposed farmers and the impact of genetic polymorphisms (as susceptibility biomarkers) on the increased risk of chromosomal damage is still limited. The aim of our study was to evaluate chromosomal alterations, chromosomal instability, and clonal heterogeneity, as well as the presence of polymorphic variants in the GSTP1 and XRCC1 genes, in peripheral blood samples of farmers occupationally exposed to pesticides in Aquitania, Colombia, and in an unexposed control group. Our results showed statistically significant differences in the frequency of numerical chromosomal alterations, chromosomal instability, and clonal heterogeneity levels between the exposed and unexposed groups. In addition, we also found a higher frequency of chromosomal instability and clonal heterogeneity in exposed individuals carrying the heterozygous GSTP1 AG and XRCC1 (exon 10) GA genotypes. The evaluation of chromosomal alterations and chromosomal instability resulting from pesticide exposure, combined with the identification of polymorphic variants in the GSTP1 and XRCC1 genes, and further research involving a larger group of individuals exposed to pesticides could enable the identification of effect and susceptibility biomarkers. Such markers could prove valuable for monitoring individuals occupationally exposed to pesticides.

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This research analyzed, optimized and modeled the inactivation kinetics of pathogenic bacteria (PB1: Escherichia coli O157:H7 and PB2: Listeria monocytogenes) and determined the microbiological safety of tomato juice processed by UV-LED irradiation and heat treatment. UV-LED processing conditions were optimized using response surface methodology (RSM) and were 90% power intensity, 21 min and 273-275 nm (251 mJ/cm2) with R2 > 0.96. Using the optimal conditions, levels of PB1 and PB2 resulted a log reduction of 2.89 and 2.74 CFU/mL, respectively. The Weibull model was efficient for estimating the log inactivation of PB1 and PB2 (CFU/mL). The kinetic parameter δ showed that 465.2 mJ/cm2 is needed to achieve a 90% log (CFU/mL) reduction in PB1 and 511.3 mJ/cm2 for PB2. With respect to the scale parameter p > 1, there is a descending concave curve. UV-LED-treated tomato juice had an 11.4% lower Listeria monocytogenes count than heat-treated juice on day 28 (4.0 ± 0.82 °C). Therefore, UV-LED technology could be used to inactivate Escherichia coli O157:H7 and Listeria monocytogenes, preserving tomato juice for microbiological safety, but studies are required to further improve the inactivation of these pathogens and analyze other fruit and vegetable juices.

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The aim of this study was the molecular imprinting polymers (MIPs) assessment as a controlled release system of ciprofloxacin. The MIPs synthesis was performed by three different methods: emulsion, bulk, and co-precipitation. Lactic acid (LA) and methacrylic acid (MA) were used as functional monomers and ethylene glycol dimethacrylate as crosslinker. Also, nonimprinted polymers (NIPs) were synthesized. MIPs and NIPs were characterized by scanning electron microscopy, Fourier Transform Infrared Reflection, specific surface area, pore size, and release kinetics. Their efficiency against Staphylococcus aureus and Escherichia coli, and their cytotoxicity in dermal fibroblast cells were proven. Results show that MIPs are mesoporous materials with a pore size between 10 and 20 nm. A higher adsorption with the co-precipitation MIP with MA as a monomer was found. The release kinetics proved that a non-Fickian process occurred and that the co-precipitation MIP with LA presented the highest release rate (90.51 mg/L) in 8 h. The minimum inhibitory concentration was found between 0.031 and 0.016 mg/L for Staphylococcus aureus and between 0.004 and 0.031 mg/L for the Escherichia coli. No cytotoxicity in cellular cultures was found; also, cellular growth was favored. This study demonstrated that MIPs present promising properties for drug administration and their application in clinical practice.

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Genomics has significantly revolutionized pathogen surveillance, particularly in epidemiological studies, the detection of drug-resistant strains, and disease control. Despite its potential, the representation of Latin American countries in the genomic catalogues of Mycobacterium tuberculosis (Mtb), the bacteria responsible for Tuberculosis (TB), remains limited. In this study, we present a whole genome sequencing (WGS)-based analysis of 85 Mtb clinical strains from 17 Mexican states, providing insights into local adaptations and drug resistance signatures in the region. Our results reveal that the Euro-American lineage (L4) accounts for 94% of our dataset, showing 4.1.2.1 (Haarlem, n = 32), and 4.1.1.3 (X-type, n = 34) sublineages as the most prevalent. We report the presence of the 4.1.1.3 sublineage, which is endemic to Mexico, in six additional locations beyond previous reports. Phenotypic drug resistance tests showed that 34 out of 85 Mtb samples were resistant, exhibiting a variety of resistance profiles to the first-line antibiotics tested. We observed high levels of discrepancy between phenotype and genotype associated with drug resistance in our dataset, including pyrazinamide-monoresistant Mtb strains lacking canonical variants of drug resistance. Expanding the Latin American Mtb genome databases will enhance our understanding of TB epidemiology and potentially provide new avenues for controlling the disease in the region.

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CASE REPORT: We report the first case of orbital myeloid sarcoma that was successfully treated with a standard venetoclax dose of 25%. A 38-year-old man with acute myeloid leukemia (AML) post-haplo-hematopoietic stem cell transplantation (HSCT) presented with a nine-month history of progressive right proptosis and a visual acuity deficit. The patient was treated with venetoclax (100 mg orally on days 1-28), cytarabine (40 mg subcutaneously, days 1-10), and itraconazole (100 mg twice daily orally on days 1-28). MANAGEMENT AND OUTCOME: The present case report shows that using cytochrome P450 (CYP) inhibitors is a helpful strategy to reduce the cost of expensive treatments. DISCUSSION: There are limited data on the use of CYP inhibitors as a strategy to reduce the costs of expensive drugs (i.e. venetoclax). This approach has some advantages over standard dose venetoclax (400 mg/day) such as significantly reduced costs (which is relevant for patients in low-income countries). In this case, we used itraconazole-a potent CYP3A4 inhibitor-which can theoretically reduce the dose to 100 mg/day without losing serum therapeutic concentrations.

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The inhibition of cytochrome P450 (CYP) enzymes is the most frequent cause of drug-drug interactions. Many safe, inexpensive and widely available therapeutic drugs can inhibit CYP enzymes (e.g., azoles). Also, the specific potency of inhibition and the targeted CYP enzyme have been well described (e.g., itraconazole strongly inhibits CYP enzyme 3A4 and, in turn, CYP3A4 metabolizes venetoclax and ibrutinib). CYP enzyme inhibitors increase the plasma concentration of other drugs via shared metabolic pathways. We herein present the effects of inhibiting CYP enzymes with itraconazole-venetoclax for the treatment of refractory acute myeloid leukaemia, as well as itraconazole-ibrutinib to treat steroid-refractory acute graft vs. host disease in the same patient. Both of the patient's conditions responded completely. This appears to be a feasible strategy that decreases treatment costs by 75%. Previous Food and Drug Administration recommendations and clinical data support these subsequent dose reductions. Eleven months after the transplant, the patient remains in complete response and with no minimal residual disease. Another patient had been effectively treated before with CYP enzyme inhibition prior to venetoclax-itraconazole administration for orbital myeloid sarcoma. Thus, this case study furthers information on the CYP enzyme inhibition strategy when associated with another costly drug, ibrutinib. The CYP enzyme inhibition strategy could be applied to many more anticancer drugs (e.g., ruxolitinib and ponatinib) and facilitate the availability of expensive oncological treatments in low- and middle-income countries. Also, this strategy could be further generalized by using different CYP enzyme inhibitors with varied pharmacokinetic and pharmacodynamic properties (i.e., grapefruit, azoles and clarithromycin).

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Ultraviolet light-emitting diode (UV-LED) technology has emerged as a non-thermal and non-chemical treatment for preserving liquid fruit and vegetable foods. This technology uses ultraviolet light to interact with the food at different wavelengths, solving problems related to product stability, quality, and safety during storage. UV-LED treatment has been shown to affect microbe and enzyme inactivation, and it increases and improves retention of bioactive compounds. Moreover, computational simulations are a powerful and relevant tool that can be used optimize and improve the UV-LED process. Currently, there are a limited studies of this technology in liquid fruit and vegetable-based foods. This review gathers information on these food type and shows that it is a promising technology for the development of new products, is environmentally friendly, and does not require the addition of chemicals nor heat. This is relevant from an industrial perspective because maintaining the nutritional and organoleptic properties ensures better quality. However, due to the scarce information available on this type of food, further studies are needed.

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Systematic modeling of the enzymatic hydrolysis of milk proteins is needed to assist the study and production of partially hydrolyzed milk. The enzymatic hydrolysis of milk proteins was characterized and evaluated as a function of the temperature and protease concentration using Alcalase, Neutrase and Protamex. Modeling was based on the combination of two empirical models formed by a logarithmic and a polynomial equation to correlate the kinetic constants and the operating conditions. The logarithmic equation fitted with high accuracy to the experimental hydrolysis curves with the three proteases (R2 > 0.99). The kinetic constants were correlated with the operating conditions (R2 > 0.97) using polynomial equations. The temperature and protease concentration significantly affected the initial rate of hydrolysis, i.e., the kinetic constant a, while the kinetic constant b was not significantly affected. The values for the kinetic constant a were predicted according to the operating conditions and they were strongly correlated with the experimental data (R2 = 0.95). The model allowed for a high-quality prediction of the hydrolysis curves of milk proteins. This modeling tool can be used in future research to test the correlation between the degree of hydrolysis and the functional properties of milk hydrolysates.

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Abstract Objective: To explore the diagnostic utility of 31 electrocardiogram (ECG) criteria for detecting echocardiographic (Echo) left ventricular geometry using accuracy. Methods: This cross-sectional study included consecutive adults (> 18 years) that were classified by Echo left ventricular geometry as normal (NL), concentric remodeling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH). Thirty-one state-of-the-art ECG criteria for Echo left ventricular hypertrophy were calculated. AUC 95%CI, accuracy, sensitivity, specificity, and positive and negative predictive value for detecting Echo left ventricular geometries were compared. Multivariable linear regression models were produced using the ECG criteria as the dependent variable. Results: A total of 672 adults were included in the study. From 31 ECG criteria, Cornell (ECG21, SV3 + RaVL) and modified Cornell (ECG 31, RaVL + deepest S in all leads) criteria have the best overall AUC in differentiating NL versus CH (0.666 and 0.646), NL versus EH (0.686 and 0.656), CR versus CH (0.687 and 0.661), and CR versus EH (0.718 and 0.676). In multivariable linear regression models, CH and EH had the strongest effect on the final voltage in Cor- nell (ECG21) and modified Cornell (ECG31). Conclusions: From 31 state-of-the-art criteria, Cornell and modified Cornell criteria have the best AUC and accuracy for predicting most left ventricular geometries. CH and EH had the strongest effect on the voltage of Cornell and modified Cornell criteria compared to body mass index, age, diabetes, hypertension, and chronic heart disease. The ECG criteria poorly differentiate NL from CR and CH from EH.

Resumen Objetivo: Explorar la utilidad diagnóstica de 31 criterios de ECG para detectar la geometría ecocardiográfica del ventrículo izquierdo usando la exactitud, área bajo la curva, sensibilidad, especificidad, y valor predictivo positivo y negativo. Métodos: Este estudio transversal incluyó adultos (> 18 años) que se sometieron a ECG y ecocardiograma transtorácico. Los pacientes fueron clasificados según la geometría del ventrículo izquierdo: normal (NL), remodelado concéntrico (RC), hipertrofia concéntrica (HC) e hipertrofia excéntrica (HE). Se calcularon 31 criterios clásicos de ECG para detectar hipertrofia ventricular izquierda y se comparó el rendimiento diagnóstico en cada geometría. Creamos un modelo de regresión lineal múltiple usando los criterios de ECG como variable dependiente. Resultados: Se incluyeron 672 adultos. Los criterios de Cornell (ECG 21, SV3 + RaVL) y Cornell modificado (ECG31, RaVL + S mas profunda de las 12 derivaciones) tienen el mejor AUC para diferenciar NL versus HC (0.666 y 0.646), NL versus HE (0.686 y 0.656), RC versus HC (0.687 y 0.661) y RC versus HE (0.718 y 0.676). En el análisis multivariado la geometría del ventrículo izquierdo (HC e HE) fue la variable que mas influyó en el resultado final del criterio de Cornell y de Cornell modificado. Conclusión: De los 31 criterios clásicos explorados, los criterios de Cornell y Cornell modificado tienen el mejor AUC y exactitud para predecir la mayoría de las geometrías del ventrículo izquierdo. Los criterios del ECG no diferencian bien la geometría NL del RC ni HC de la HE.

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OBJECTIVE: To explore the diagnostic utility of 31 electrocardiogram (ECG) criteria for detecting echocardiographic (Echo) left ventricular geometry using accuracy. METHODS: This cross-sectional study included consecutive adults (> 18 years) that were classified by Echo left ventricular geometry as normal (NL), concentric remodeling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH). Thirty-one state-of-the-art ECG criteria for Echo left ventricular hypertrophy were calculated. AUC 95%CI, accuracy, sensitivity, specificity, and positive and negative predictive value for detecting Echo left ventricular geometries were compared. Multivariable linear regression models were produced using the ECG criteria as the dependent variable. RESULTS: A total of 672 adults were included in the study. From 31 ECG criteria, Cornell (ECG21, SV3 + RaVL) and modified Cornell (ECG 31, RaVL + deepest S in all leads) criteria have the best overall AUC in differentiating NL versus CH (0.666 and 0.646), NL versus EH (0.686 and 0.656), CR versus CH (0.687 and 0.661), and CR versus EH (0.718 and 0.676). In multivariable linear regression models, CH and EH had the strongest effect on the final voltage in Cor- nell (ECG21) and modified Cornell (ECG31). CONCLUSIONS: From 31 state-of-the-art criteria, Cornell and modified Cornell criteria have the best AUC and accuracy for predicting most left ventricular geometries. CH and EH had the strongest effect on the voltage of Cornell and modified Cornell criteria compared to body mass index, age, diabetes, hypertension, and chronic heart disease. The ECG criteria poorly differentiate NL from CR and CH from EH.

OBJETIVO: Explorar la utilidad diagnóstica de 31 criterios de ECG para detectar la geometría ecocardiográfica del ventrículo izquierdo usando la exactitud, área bajo la curva, sensibilidad, especificidad, y valor predictivo positivo y negativo. ­. MÉTODOS: Este estudio transversal incluyó adultos (> 18 años) que se sometieron a ECG y ecocardiograma transtorácico. Los pacientes fueron clasificados según la geometría del ventrículo izquierdo: normal (NL), remodelado concéntrico (RC), hipertrofia concéntrica (HC) e hipertrofia excéntrica (HE). Se calcularon 31 criterios clásicos de ECG para detectar hipertrofia ventricular izquierda y se comparó el rendimiento diagnóstico en cada geometría. Creamos un modelo de regresión lineal múltiple usando los criterios de ECG como variable dependiente. RESULTADOS: Se incluyeron 672 adultos. Los criterios de Cornell (ECG 21, SV3 + RaVL) y Cornell modificado (ECG31, RaVL + S mas profunda de las 12 derivaciones) tienen el mejor AUC para diferenciar NL versus HC (0.666 y 0.646), NL versus HE (0.686 y 0.656), RC versus HC (0.687 y 0.661) y RC versus HE (0.718 y 0.676). En el análisis multivariado la geometría del ventrículo izquierdo (HC e HE) fue la variable que mas influyó en el resultado final del criterio de Cornell y de Cornell modificado. CONCLUSIÓN: De los 31 criterios clásicos explorados, los criterios de Cornell y Cornell modificado tienen el mejor AUC y exactitud para predecir la mayoría de las geometrías del ventrículo izquierdo. Los criterios del ECG no diferencian bien la geometría NL del RC ni HC de la HE.

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Immune thrombocytopenia (ITP) is an autoimmune disease that results from antibody-mediated platelet destruction and impaired platelet production. Novel therapies have emerged in the last decade, but 15-20% of patients will relapse or fail and require further therapy. We performed a prospective, single-arm intervention study on seven patients with chronic, persistent, or refractory ITP from the Hospital Universitario "Dr. José E González", in Monterrey, Mexico between 2015 and 2019. Eligible patients received oral oseltamivir 75 mg twice daily for 5 days and were followed up for six months. Most patients received a median of three distinct therapies (range 2-6). Four patients (57.1%) received combined therapy. The median time for any response was 55.5 days (range = 14-150). All patients responded at some point in time (ORR = 100%, six had a proportion of loss of response [PR], and one achieved [CR]). Six months after oseltamivir administration, three patients (42.9%) maintained a response, and one patient had a CR (14.3%). Oseltamivir was well tolerated with a good overall response rate and was useful for treating chronic ITP. We observed an initial increase in the number of platelets; however, this response was not maintained.

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The unstable proteins in white wine cause haze in bottles of white wine, degrading its quality. Thaumatins and chitinases are grape pathogenesis-related (PR) proteins that remain stable during vinification but can precipitate at high temperatures after bottling. The white wine protein stabilization process can prevent haze by removing these unstable proteins. Traditionally, bentonite is used to remove these proteins; however, it is labor-intensive, generates wine losses, affects wine quality, and harms the environment. More efficient protein stabilization technologies should be based on a better understanding of the main factors and mechanisms underlying protein precipitation. This review focuses on recent developments regarding the instability and removal of white wine proteins, which could be helpful to design more economical and environmentally friendly protein stabilization methods that better preserve the products´ quality.

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Surgery for Pectus Excavatum is associated with intense postoperative pain and the need for múltiple analgesic therapies that include regional blocks such as the erector spinae. The evidence supports this block due to its effectiveness and the possibility of locating a catheter to continuously administer interfacial local anesthetic. To date, there are few reports on its use as an analgesic strategy for this surgery and based on this, this is the first reported case of continuous and effective analgesia using this block at the bilateral thoracic level for the placement of a NUSS bar as the only analgesic method for postoperative analgesic in an adult patient.

La cirugía para Pectus Excavatum se asocia a intenso dolor posoperatorio y necesidad de múltiples terapias analgésicas que incluyen bloqueos regionales como el erector espinal. La evidencia apoya este bloqueo por su efectividad y la posibilidad de ubicar un catéter para administrar continuamente anestésico local interfacial. A la fecha hay pocos reportes sobre el uso del mismo como estrategia analgésica para esta cirugía y, basándose, en ello este es el primer caso reportado sobre analgesia continua y efectiva usando este bloqueo a nivel torácico bilateral para la colocación de una barra de NUSS como único método analgésico postoperatorio en un paciente adulto.

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BACKGROUND: Left ventricular hypertrophy detected by echocardiography (Echo-LVH) is an independent predictor of mortality. Integration of the Philips DXL-16 algorithm into the electrocardiogram (ECG) extensively analyses the electricity of the heart. Machine learning techniques such as the C5.0 could lead to a new decision tree criterion to detect Echo-LVH. OBJECTIVES: To search for a new combination of ECG parameters predictive of Echo-LVH. The final model is called the Cardiac Hypertrophy Computer-based model (CHCM). METHODS: We extracted the 458 ECG parameters provided by the Philips DXL-16 algorithm in patients with Echo-LVH and controls. We used the C5.0 ML algorithm to train, test, and validate the CHCM. We compared its diagnostic performance to validate state-of-the-art criteria in our patient cohort. RESULTS: We included 439 patients and considered an alpha value of 0.05 and a power of 99%. The CHCM includes T voltage in I (≤0.055 mV), peak-to-peak QRS distance in aVL (>1.235 mV), and peak-to-peak QRS distance in aVF (>0.178 mV). The CHCM had an accuracy of 70.5% (CI95%, 65.2-75.5), a sensitivity of 74.3%, and a specificity of 68.7%. In the external validation cohort (n = 156), the CHCM had an accuracy of 63.5% (CI95%, 55.4-71), a sensitivity of 42%, and a specificity of 82.9%. The accuracies of the most relevant state-of-the-art criteria were: Romhilt-Estes (57.4%, CI95% 49-65.5), VDP Cornell (55.7%, CI95%47.6-63.7), Cornell (59%, CI95%50.8-66.8), Dalfó (62.9%, CI95%54.7-70.6), Sokolow Lyon (53.9%, CI95%45.7-61.9), and Philips DXL-16 algorithm (54.5%, CI95%46.3-62.5). CONCLUSION: ECG computer-based data and the C5.0 determined a new set of ECG parameters to predict Echo-LVH. The CHCM classifies patients as Echo-LVH with repolarization abnormalities or LVH with increased voltage. The CHCM has a similar accuracy, and is slightly more sensitive than the state-of-the-art criteria.

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