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Background: E-cigarettes are often marketed as a less harmful alternative to traditional tobacco cigarettes. Despite their popularity, the evidence regarding their effects on human health remains unclear and is filled with complexities. Objectives: This systematic review aims to elucidate the direct effects of electronic cigarette use on human health, carefully distinguishing between the specific characteristics of the populations studied. Methodology: Adhering to the PRISMA guidelines, we conducted a comprehensive search in PubMed/Medline, Web of Science, Scopus, and Google Scholar databases without date restrictions, including articles in both Spanish and English. This approach enabled the identification and analysis of primary studies to understand the direct effect of electronic cigarettes on human health. Results: A total of 33 studies were included that evaluated cardiovascular, pulmonary, renal, weight and fertility effects. Only five studies analyzed e-cigarettes in healthy populations and seven studies compared healthy individuals against smokers. The effects evaluated on smokers or former tobacco smokers were apparently positive, however, among healthy individuals, increased heart rate, mean arterial pressure, oxidative stress, alteration of respiratory epithelial cells and increased airflow resistance were found. Conclusion: Smokers or former smokers who switch to e-cigarettes may reduce their exposure to carcinogens and lower their risk of developing severe health issues associated with conventional smoking. However, in healthy individuals who have never smoked traditional cigarettes, the use of e-cigarettes introduces several cardiovascular and respiratory adverse effects. These findings suggest that while e-cigarettes can be a strategic harm reduction tool for smokers, they are not a safe option for non-smokers.

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Perovskite solar cells (PSCs) have rapidly developed into one of the most attractive photovoltaic technologies, exceeding power conversion efficiencies of 25% and as the most promising technology to complement silicon-based solar cells. Among different types of PSCs, carbon-based, hole-conductor-free PSCs (C-PSCs), in particular, are seen as a viable candidate for commercialization due to the high stability, ease of fabrication, and low cost. This review examines strategies to increase charge separation, extraction, and transport properties in C-PSCs to improve the power conversion efficiency. These strategies include the use of new or modified electron transport materials, hole transport layers, and carbon electrodes. Additionally, the working principles of various printing techniques for the fabrication of C-PSCs are presented, as well as the most remarkable results obtained from each technique for small-scale devices. Finally, the manufacture of perovskite solar modules using scalable deposition techniques is discussed.

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Resumen Introducción: El ecocardiograma es el método de referencia para el diagnóstico del conducto arterioso permeable (CAP) hemodinámicamente significativo (CAP-hs) del recién nacido prematuro (RNP). El péptido natriurético tipo B (BNP) puede ser útil en el diagnóstico y el manejo del CAP-hs. Objetivo: Evaluar la utilidad del BNP como marcador de sobrecarga hemodinámica del conducto arterioso permeable en el RNP con edad gestacional < 32 semanas o peso < 1500 gramos, e identificar el mejor punto de corte para los valores de BNP que mejor prediga un CAP con repercusión hemodinámica que requiera tratamiento farmacológico o quirúrgico. Método: Estudio retrospectivo, observacional y descriptivo de RNP < 32 semanas de gestación o peso < 1500 gramos en los que se realizó ecocardiograma y determinación del BNP. Análisis de muestra global y por subgrupos, en función del CAP-hs. Resultados: Se analizaron 29 pacientes. Se encontró una correlación significativa entre la relación CAP/peso y los valores del BNP (prueba de Spearman: 0.71; intervalo de confianza del 95%: 0.45-0.87; p < 0.001). El mejor punto de corte del BNP para predecir CAP-hs fue 486.5 pg/ml, con una sensibilidad del 81% y una especificidad del 92% (p < 0.001). Conclusión: El punto de corte del BNP identificado en el presente estudio se correlacionó con la presencia de CAP-hs.

Abstract Introduction: The echocardiogram is the gold standard, in the diagnosis of the hemodynamically significant patent ductus arteriosus (hs-PDA) of the premature newborn (PNB). Type B natriuretic peptide (BNP) may be useful in the diagnosis and management of CAP-hs. Objective: To assess the utility of BNP as a marker of hemodynamic overload of the patent ductus arteriosus in newborns with gestational age < 32 weeks or weight < 1500 grams, and to identify the best cut-off point for BNP levels that would best predict a PDA with hemodynamic impact requiring pharmacological and/or surgical treatment. Methods: Retrospective, observational and descriptive study of PNB < 32 weeks gestation or weight < 1500 grams, in which echocardiogram and BNP determination was performed. Analysis of the global sample and by subgroups, depending on the hs-PDA status was performed. Results: A total of 29 patients were analyzed. A significant correlation was found between the PDA/weight ratio and BNP levels (Spearman: 0.71; 95% confidence interval: 0.45-0.87; p < 0.001). The best BNP cut-off point to predict CAP-hs was 486.5 pg/ml with a sensitivity of 81% and specificity of 92% (p < 0.001). Conclusion: The BNP cut-off point identified in the present study was correlated with the presence of CAP-hs.

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Introducción: El ecocardiograma es el método de referencia para el diagnóstico del conducto arterioso permeable (CAP) hemodinámicamente significativo (CAP-hs) del recién nacido prematuro (RNP). El péptido natriurético tipo B (BNP) puede ser útil en el diagnóstico y el manejo del CAP-hs. Objetivo: Evaluar la utilidad del BNP como marcador de sobrecarga hemodinámica del conducto arterioso permeable en el RNP con edad gestacional < 32 semanas o peso < 1500 gramos, e identificar el mejor punto de corte para los valores de BNP que mejor prediga un CAP con repercusión hemodinámica que requiera tratamiento farmacológico o quirúrgico. Método: Estudio retrospectivo, observacional y descriptivo de RNP < 32 semanas de gestación o peso < 1500 gramos en los que se realizó ecocardiograma y determinación del BNP. Análisis de muestra global y por subgrupos, en función del CAP-hs. Resultados: Se analizaron 29 pacientes. Se encontró una correlación significativa entre la relación CAP/peso y los valores del BNP (prueba de Spearman: 0.71; intervalo de confianza del 95%: 0.45-0.87; p < 0.001). El mejor punto de corte del BNP para predecir CAP-hs fue 486.5 pg/ml, con una sensibilidad del 81% y una especificidad del 92% (p < 0.001). Conclusión: El punto de corte del BNP identificado en el presente estudio se correlacionó con la presencia de CAP-hs.

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RESUMEN Fundamento: las emergencias hipertensivas pueden ser la presentación de una enfermedad renal crónica subyacente, a su vez el daño renal puede ser la causa que lleve a la emergencia hipertensiva. El filtrado glomerular teórico es recomendable para evaluar el riesgo de morbilidad y mortalidad en las emergencias hipertensivas. Objetivo: describir el comportamiento del filtrado glomerular en pacientes con emergencias hipertensivas atendidos en el Hospital Clínico Quirúrgico Julio Trigo López en el período 2016 a 2018. Métodos: se realizó un estudio prospectivo, de cohorte a pacientes con emergencias hipertensivas atendidos en el Hospital Clínico Quirúrgico Julio Trigo López en el período 2016-2018. Se incluyeron 136 pacientes que cumplieron con los criterios de inclusión en el estudio. Se realizó el cálculo del filtrado glomerular y fueron seguidos hasta el año en la consulta de hipertensión. Resultados: la media de la edad fue de 61,6 años (SD ± 13,6 años), la prevalencia de Fge<60 ml/min/1,73 m2 fue del 30,9 %. Los pacientes con daño renal mostraron mayor edad promedio (63,5 años; DE ± 13,9 años), mayor prevalencia de diabetes (61,9 %; OR 5,318; IC9 5% 2,731 - 6,992; p < 0,001), mortalidad intra y extra hospitalaria 8,8 % (OR: 2,44; IC 95 %: 1,933 - 2,902; p < 0,001) y 14,5 % (RR: 2,264; IC 95 %: 2,151 - 3,476; p < 0,001) respectivamente en comparación con aquellos que no tenían daño renal. Conclusiones: los pacientes con emergencias hipertensivas que presentan daño renal tienen peor pronóstico por lo que se justifica en ellos un seguimiento y tratamiento más estricto.

ABSTRACT Foundation: hypertensive emergencies may be the presentation of an underlying chronic kidney disease; in turn kidney damage may be the cause that leads to hypertensive emergency. Theoretical glomerular filtration is recommended to assess the risk of morbidity and mortality in hypertensive emergencies. Objective: to describe the behavior of glomerular filtration in patients with hypertensive emergencies attended at the Julio Trigo López Clinical Hospital in the period of 2016. Methods: a prospective cohort study of patients with hypertensive emergencies attended at the Julio Trigo López Hospital in the 2016-2018 period was performed. A total of 136 patients who met the inclusion criteria were included in the study. Glomerular filtration was calculated and patients were followed up to one year in the hypertension clinic. Results: mean age was 61.6 years (SD ± 13.6 years), prevalence of Fge <60 ml / min / 1.73 m2 was 30.9 %. Patients with kidney damage showed higher mean age (63.5 years; SD ± 13.9 years), higher prevalence of diabetes (61.9 %; OR 5,318; CI9 5 % 2,731 - 6,992; p <0.001), intra and extra hospital mortality 8.8% (OR: 2.44; IC 95 %: 1,933 - 2,902; p <0.001) and 14.5% (RR: 2,264; 95 % CI: 2,151 - 3,476; p <0.001) respectively compared to those without kidney damage. Conclusions: patients with hypertensive emergencies who have kidney damage have a worse prognosis, so a more strict follow-up and treatment are justified.

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Rodents are reservoirs and hosts of several pathogens around the world, including zoonotic parasite species. This study aimed to determine the occurrence of zoonotic gastrointestinal helminths in rodents captured inside households in a rural community from southern Guatemala. Sixty-nine rodents were captured in 33% (49/148) of the surveyed households, including Rattus rattus, Rattus norvegicus, Mus musculus, and Sigmodon hispidus. Thirty-six percent (25/69) of these rodents (3 Rattus and 22 Mus musculus), from 45% (22/49) of the households, were parasitized with at least 1 gastrointestinal helminth species. Helminths from 6 species were identified: Hymenolepis diminuta, Moniliformis moniliformis, Heterakis spumosa, Nippostrongylus sp., Strongyloides sp., and Syphacia sp. Two zoonotic species were found in Rattus, H. diminuta in R. rattus (1/6), and M. moniliformis in R. norvegicus (1/1). Coinfection with other non-zoonotic helminth parasites, such as He. spumosa and Strongyloides sp., also was observed in the Rattus genus. Mus musculus had only non-zoonotic helminths: He. spumosa, Nippostrongylus sp., and Syphacia sp. being the most common, and He. spumosa (96%) followed by Nippostrongylus sp. (48%), with a higher presence in males than females, with a similar proportion in adult and young individuals. This is the first report of zoonotic and non-zoonotic helminths parasites in rodents from Guatemala.

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Introducción: La enfermedad renal crónica expresada por un filtrado glomerular disminuido se asocia a un mayor riesgo de enfermedad cardiovascular y a mayor progresión del daño renal. Es muy recomendable como método disponible y económico para evaluar el riesgo cardiovascular en hipertensos. Objetivo: Evaluar el daño renal y la enfermedad cardiovascular en hipertensos del Policlínico Managua. Método: Se estudiaron 1037 pacientes hipertensos. Se calculó el filtrado glomerular según el Modification Diet Renal Disease Study. Se estudiaron variables demográficas, factores de riesgo vascular y presencia de enfermedad cardiovascular. Se definió 60 mil/min/1,73m2 para el filtrado glomerular disminuido. Resultados: De los pacientes estudiados, 28,5 por ciento presentaron filtrado glomerular disminuido, mostrando mayor prevalencia de enfermedad cardiovascular que aquellos sin daño renal (53,4 por ciento vs 33,9 por ciento; OR 2,19 IC 95 por ciento 1,51-2,82; p ; 0,001). Conclusiones: Este estudio muestra que la enfermedad renal crónica se asocia a mayor prevalencia de enfermedad cardiovascular, siendo un factor de riesgo cardiovascular mayor(AU)

Introduction: Chronic kidney disease expressed by decreased glomerular filtration rate is associated with high risk of cardiovascular disease and great progression of kidney damage. This filtration is highly recommended as an available and inexpensive method to assess cardiovascular risk in hypertensive patients. Objective: To assess kidney damage and cardiovascular disease in hypertensive patients at Managua Polyclinic. Method: This research included 1037 hypertensive patients. Glomerular filtration was calculated according to the Modification Diet Renal Disease Study. Demographic variables, vascular risk factors, and the presence of cardiovascular disease were studied. The decreased glomerular filtration was defined for ;60 thousand/min/1.73m2. Results: 28.5 percent of the studied patients showed decreased glomerular filtration, higher prevalence of cardiovascular disease than those without kidney damage (53.4 percent ;vs. 33.9 percent; OR 2.19 95 percent CI 1.51-2, 82; p ;0.001). Conclusions: This study showed that chronic kidney disease is associated with high prevalence of cardiovascular disease, which establishes higher cardiovascular risk factor(AU)

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BACKGROUND: Medullary ischemia secondary to surgical procedures of the infrarenal aorta is an infrequent and mostly devastating complication of this procedure, and its nonspecific clinical presentation makes it difficult to promptly diagnose. Prevention measures for this complication are not yet clear; therefore, the need for anticoagulant and/or antiplatelet therapy is discussed. CASE PRESENTATION: This paper reports a case of a 69-year-old Hispanic man presenting with sudden pain and signs of ischemia on his left lower extremity 8 weeks after endovascular repair with endoprosthesis of an infrarenal aorta and left iliac aneurysm. The patient was admitted to the emergency room, where an extensive arterial thrombosis compromising the right iliac and femoral arteries was diagnosed. Dual anticoagulation and antiplatelet therapies were initiated, and therapeutic ranges were achieved. Nonetheless, the patient presented medullary ischemia by microembolization diagnosed by contrast-enhanced magnetic resonance imaging, with unsatisfactory evolution of an intracranial hemorrhagic event without documented excessive anticoagulation. The patient developed permanent pure motor deficit of his lower extremities, absence of sphincter control, and mild cognitive impairment. CONCLUSIONS: This is a complex and extremely rare case. It is important to continue with clinical investigations that give more clarity about the onset of anticoagulation, antiplatelet therapy, and management of dual schemes to decrease the risk of complications in this type of surgical procedure.

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In tropical trees, forest fragmentation has been shown to affect mating and gene flow patterns. Mobile dispersal vectors should be less sensitive to fragmented landscapes and may ameliorate the genetic effects of forest fragmentation on plant populations. To test this hypothesis, we analyzed gene flow patterns in Symphonia globulifera, a tropical tree species with highly mobile pollinators and seed dispersers in the Osa Peninsula in southern Costa Rica. We used microsatellites to study genetic diversity and realized gene flow patterns between a continuous forest and a forest fragment. We found high levels of genetic diversity in adults and seedlings at both sites. Parentage analyses suggest near-neighbor matings and frequent long-distance gene flow events. Half the progeny beneath an adult was not sired by that tree and the majority of established seedlings were the result of long-distance gene dispersal. Gene flow from the forest into the fragment was more common than from the fragment into the continuous forests. Despite long distance gene flow events, seedling spatial genetic structure was stronger and extended further in the forest fragment likely due to limited seed dispersal. We conclude that fragmentation affects gene flow in this tropical tree and may compromise its genetic diversity in forest fragments even for a species with mobile pollen and seed vectors.

En árboles tropicales se ha demostrado que la fragmentación del bosque afecta los patrones de apareamiento y reduce el flujo génico. Las especies forestales cuyos dispersores y polinizadores son capaces de moverse largas distancias sobre ambientes alterados, serán menos sensibles a los efectos de la fragmentación y podrán intercambiar genes regularmente entre fragmentos. Para probar esta hipótesis, en la Península de Osa en el sur de Costa Rica, estudiamos los patrones de flujo génico de Symphonia globulifera, una especie de árbol tropical con polinizadores y dispersores de semillas altamente móviles. Utilizamos microsatélites para estudiar la diversidad genética y los patrones de flujo génico entre un bosque continuo y un fragmento de bosque. Encontramos altos niveles de diversidad genética tanto en adultos como en plántulas. Los análisis de parentesco indican apareamiento entre vecinos cercanos, sin embargo el flujo génico a larga distancia es frecuente. La mitad de la progenie debajo de un adulto no es engendrada por ese árbol y la mayoría de las plántulas establecidas son el resultado del flujo génico a larga distancia. El flujo de genes desde el bosque continuo hacia el fragmento era más frecuente que el movimiento inverso. A pesar del flujo génico a larga distancia, hay diferencias en frecuencias alélicas entre plántulas y la estructura espacial era más fuerte y se extendía a mayor distancia en el fragmento, probablemente por una dispersión limitada de semillas. Concluimos que la fragmentación afecta los patrones de flujo génico en esta especie de árbol tropical y puede afectar su diversidad genética en paisajes fragmentados, inclusive para una especies con polinizadores y dispersores con alta movilidad.

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Human astrovirus (HAstV) constitutes a major cause of acute gastroenteritis in children. The viral 5' and 3' untranslated regions (UTR) have been involved in the regulation of several molecular mechanisms. However, in astrovirues have been less characterized. Here, we analyzed the secondary structures of the 5' and 3' UTR of HAstV, as well as their putative target sites that might be recognized by cellular factors. To our knowledge, this is the first bioinformatic analysis that predicts the HAstV 5' UTR secondary structure. The analysis showed that both the UTR sequence and secondary structure are highly conserved in all HAstVs analyzed, suggesting their regulatory role of viral activities. Notably, the UTRs of HAstVs contain putative binding sites for the serine/arginine-rich factors SRSF2, SRSF5, SRSF6, SRSF3, and the multifunctional hnRNPE2 protein. More importantly, putative binding sites for PTB were localized in single-stranded RNA sequences, while hnRNPE2 sites were localized in double-stranded sequence of the HAstV 5' and 3' UTR structures. These analyses suggest that the combination of SRSF proteins, hnRNPE2 and PTB described here could be involved in the maintenance of the secondary structure of the HAstVs, possibly allowing the recruitment of the replication complex that selects and recruits viral RNA replication templates.

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BACKGROUND: Diabetic retinopathy (DR) and diabetic macular edema (DME) are potentially blinding, microvascular retinal diseases in people with diabetes mellitus. Preclinical studies support a protective role of the hormone prolactin (PRL) due to its ocular incorporation and conversion to vasoinhibins, a family of PRL fragments that inhibit ischemia-induced retinal angiogenesis and diabetes-derived retinal vasopermeability. Here, we describe the protocol of an ongoing clinical trial investigating a new therapy for DR and DME based on elevating the circulating levels of PRL with the prokinetic, dopamine D2 receptor blocker, levosulpiride. METHODS: It is a prospective, randomized, double-blind, placebo-controlled trial enrolling male and female patients with type 2 diabetes having DME, non-proliferative DR (NPDR), proliferative DR (PDR) requiring vitrectomy, and DME plus standard intravitreal therapy with the antiangiogenic agent, ranibizumab. Patients are randomized to receive placebo (lactose pill, orally TID) or levosulpiride (75 mg/day orally TID) for 8 weeks (DME and NPDR), 1 week (the period before vitrectomy in PDR), or 12 weeks (DME plus ranibizumab). In all cases the study medication is taken on top of standard therapy for diabetes, blood pressure control, or other medical conditions. Primary endpoints in groups 1 and 2 (DME: placebo and levosulpiride), groups 3 and 4 (NPDR: placebo and levosulpiride), and groups 7 and 8 (DME plus ranibizumab: placebo and levosulpiride) are changes from baseline in visual acuity, retinal thickness assessed by optical coherence tomography, and retinal microvascular abnormalities evaluated by fundus biomicroscopy and fluorescein angiography. Changes in serum PRL levels and of PRL and vasoinhibins levels in the vitreous between groups 5 and 6 (PDR undergoing vitrectomy: placebo and levosulpiride) serve as proof of principle that PRL enters the eye to counteract disease progression. Secondary endpoints are changes during the follow-up of health and metabolic parameters (blood pressure, glycated hemoglobin, and serum levels of glucose and creatinine). A total of 120 patients are being recruited. DISCUSSION: This trial will provide important knowledge on the potential benefits and safety of elevating circulating and intraocular PRL levels with levosulpiride in patients with DR and DME. ETHICS AND DISSEMINATION: Ethics approval has been obtained from the Ethics Committees of the National University of Mexico (UNAM) and the Instituto Mexicano de Oftalmología, I.A.P. Dissemination will include submission to peer-reviewed scientific journals and presentation at congresses. CLINICAL TRIAL REGISTRATION: Registered at www.ClinicalTrials.gov, ID: NCT03161652 on May 18, 2017.

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The abdominal aorta of the rabbit has been in the focus of research to develop new platforms of training diagnostic and therapeutic protocols; and for testing endovascular devices and materials, however, few descriptions of the anatomy of the abdominal aorta and its emerging visceral branches has been reported on the scientific literature for this specie. Anatomical variations are common and should have in mind during research and clinical trials. The aim of this study was to describe the different patterns that can occur in the visceral branches arising from the abdominal aorta in the rabbit.

La aorta abdominal del conejo ha sido objeto de estudio e investigación para desarrollar nuevas plataformas de entrenamiento para protocolos diagnósticos y terapéuticos así como para probar las virtudes de materiales y equipos endovasculares, sin embargo, existen muy pocas descripciones en la literatura de las ramas viscerales que emergen de la aorta abdominal en esta especie. Las variaciones anatómicas son eventos de ocurrencia común y por lo tanto deben ser considerados para realizar investigación y ensayos clínicos. El objetivo del presente estudio ha sido describir los diferentes patrones que pueden presentar las ramas viscerales que emergen de la aorta abdominal en el conejo.

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PREMISE OF THE STUDY: Selfing and mixed mating systems are prevalent in many flowering plants. Purging of genetic load can occur in these species, reducing negative effects of selfing. Long-term studies of the temporal and spatial variation of selfing rates and inbreeding depression at the individual level are necessary to understand the forces that maintain selfing as a mating strategy in these species. METHODOLOGY: We used microsatellites to estimate selfing rates in seeds and seedlings over 6 years in a population of Ceiba pentandra in southwestern Costa Rica. We studied the correlation of selfing with early seedling vigor variables to test for inbreeding depression. KEY RESULTS: Selfing rates varied widely among maternal trees. However, we found high consistency of selfing rates for individuals among years. Selfing rate did not influence early fitness traits, suggesting a lack of inbreeding depression at this stage. Maternal effects were a predominant source of variation for early vigor variables. CONCLUSIONS: Variability in selfing rates among trees may be partly explained by genetic variation in a late-acting self-incompatibility system or low, early-acting genetic load in some individuals. This population did not show evidence of early inbreeding depression in traits related to seed vigor probably from complete or partial purging as a result of repeated selfing of a fraction of the population or from strong maternal effects. Expression of genetic load at later developmental stages or in more stressful natural conditions may explain differences in inbreeding levels between seeds and adults.

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INTRODUCTION: Chagas disease is the most important parasitic disease in El Salvador and Latin America. The disease has two phases: acute and chronic, with an intermediate unspecified phase. The chronic phase develops in 30% of infected persons and its most common manifestation is cardiac disease. This study aimed to obtain reference data for the prevalence of T. cruzi seropositivity in a cohort of cardiac patients. METHODOLOGY: A cross-sectional study involving consecutive heart disease patients consulting at the National Hospital Rosales was conducted over a six-month period. Congenital heart disease patients were excluded. A survey, file review, and ELISA serological test were conducted for each subject. RESULTS: Out of 455 subjects, 76 were seropositive for T. cruzi, giving a seropositivity prevalence of 16.7%. The average age of the patients was 58.09 years and the female:male ratio was 2.79:1. No significant difference was found between T. cruzi seropositive and seronegative patients in terms of age and gender. No association between T. cruzi serological status and either area of residence or seeing vectors in the house was found. However, living in the Salvadoran western region during childhood was significantly associated with seropositivity (p = 0.003). Other factors associated with T. cruzi seropositivity included: clinical diagnosis of cardiac Chagas disease; electrocardiographic (ECG) findings of a permanent pacemaker, all atrioventricular (AV) blocks and right bundle branch block; and grade III-IV radiological cardiomegaly. CONCLUSIONS: T. cruzi seropositivity prevalence was found to be 16.7% among heart disease patients in a public reference hospital.

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