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The mechanisms that negatively regulate inflammation upon a pathogenic stimulus are crucial for the maintenance of tissue integrity and organ function. T regulatory cells are one of the main drivers in controlling inflammation. The ability of T regulatory cells to adapt to different inflammatory cues and suppress inflammation is one of the relevant features of T regulatory cells. During this process, T regulatory cells express different transcription factors associated with their counterparts, Th helper cells, including Tbx21, GATA-3, Bcl6, and Rorc. The acquisition of this transcription factor helps the T regulatory cells to suppress and migrate to the different inflamed tissues. Additionally, the T regulatory cells have different mechanisms that preserve stability while acquiring a particular T regulatory cell subtype. This review focuses on describing T regulatory cell subtypes and the mechanisms that maintain their identity in health and diseases.

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Eating disorders are psychiatric and behavioral health pathologies of high complexity and different etiology, which can affect age groups, sexes, and ethnicities indistinctly. This study aimed to evaluate the risk of eating disorders and the possible relation with the sports profile of Colombian adolescent athletes. This was an exploratory cross-sectional quantitative study that used an online form designed with a sociodemographic questionnaire and the EAT-26 scale to determine the eating disorder risk of the object population. A total of 354 adolescent athletes participated. There were 182 men and 172 women and the mean age was 15.59 (range: 10-19 years, SD = 1.938). The participants presented a significantly low risk of eating disorders (21.2%) with no differences in prevalence between both sexes. The risk of eating disorder was related to the result of the last competition (p = 0.01), the type of sport (p = 0.032), the years of sports practice (p = 0.004), and the number of training hours a day (p = 0.011). It is relevant to recognize that adolescents and athletes are vulnerable populations regarding eating disorders. In conclusion, adolescent athletes should be the object of special attention to prevent eating disorders and their consequences on health and sports performance.

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Abstract Background Recently, a new heart failure (HF) classification was made considering the left ventricular ejection fraction (LVEF) phenotype. Comprehensive assessments of the groups are required to guide patient management. Objective To determine the differences in sociodemographic, clinical, functional aerobic capacity, and health-related quality of life (HRQOL) variables in patients with HF classified with different LVEFs and to explore the correlations between the variables. Methods This work is a cross-sectional descriptive and correlational study. Three groups of patients with HF (LVEF≥50%, LVEF<40%, and LVEF40-49%) were compared. Sociodemographic, clinical variables and functional aerobic capacity with Sit to Stand (STS), 6-minute walk test (6MWT), Duke Activity Status Index (DASI), Minnesota Living with HF Questionnaire (MLFHQ), and Patient Health Questionnaire 9 (PHQ-9) were considered. The Chi-square test, one-way analysis of variance (ANOVA) test, and Spearman's correlation were used for statistical analysis. The statistical significance level was set at 5%. Results A total of 209 patients were admitted with a diagnosis of HF, with a more significant number of men. Marital status was a predominantly stable union in the HF with preserved ejection fraction (HFpEF) and HF with mid-range ejection fraction (HFmrEF) groups. A sedentary lifestyle was lower in the HF with reduced ejection fraction (HFrEF) group 59 (84.3%), p-value = 0.033, and the angina pectoris was higher in the HFpEF 30 (42.9%). Systolic blood pressure at the end of the 6MWT evidenced a higher score in HFpEF 132.0±17.25 concerning HFrEF 128.0±16.57, p-value=0.043. The fat percentage was higher in HFpEF 30.20±8.80 regarding the HFmrEF group 26.51±7.60, p-value = 0.028. Conclusion There were significant differences according to the LVEF classification in marital status, angina symptoms, fat percentage, and blood pressure at rest.

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A theoretical analysis of free Gibbs Energy and NMR 1H 13C chemical shifts of the effect of introduce methyl groups on diphenyl rings, to produce different isomers of (E)-1-(α,Ꞵ-dimethylbenzylidene)-2,2-diphenylhydrazine, is presented. IR vibrational frequencies, Mulliken charges, molecular electrostatic potential (MEP), Gibbs free energy (G) and 1H- and 13C-NMR chemical shifts were obtained by theoretical calculations. In this analysis it was found that the position of the methyl group affects the values of the 1H- and 13C-NMR chemical shifts and the ∆G and ∆H thermodynamic properties of formation and reaction, these properties vary with the same trend, for the isomers studied. Gibbs free energy calculations show that the theoretical (E)-1-(3,4-Dimethylbenzylidene)-2,2-diphenylhydrazine isomer is the most stable, which explains the success of the experimental synthesis of this compound among the other isomers. For this molecule, the C of the HC=N group is the most nucleophilic and the H is the least acidic. The 1H-NMR chemical shifts of protons show a strong correlation with the C=N distance. It was also observed that methyl affects the ν(C=N) frequencies, the C=N distance increases when the inductive effect of the methyl groups is in the structure.

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Introducción: La autorregulación del aprendizaje se refiere a la modulación de los procesos afectivos, cognitivos y conductuales a lo largo de una experiencia de aprendizaje para alcanzar un nivel de logro deseado. Los estudiantes que tienen un mejor manejo de sus habilidades cognitivas y metacognitivas aprenden de una mejor forma que aquellos que no, por lo tanto, es fundamental estudiar a qué nivel los estudiantes universitarios son capaces de aprender a aprender y a ser gestores de su aprendizaje. Objetivos: Analizar la relación entre la autorregulación del aprendizaje y el rendimiento académico en estudiantes de la carrera medicina de tres universidades en el año 2022. Materiales y métodos: Esta investigación siguió un enfoque cuantitativo, el tipo de investigación fue observacional de tipo descriptivo. Se utilizó un instrumento previamente validado para identificar los tipos de autorregulación, la Autorregulación del Aprendizaje a partir de Textos (ARATEX-R). Resultados: No se encontró relación significativa entre el perfil académico de los estudiantes de medicina y el puntaje total del ARATEX-R. Al estudiar la relación entre las dimensiones de la autorregulación se encontró relación entre el rendimiento académico y la planificación y la gestión de la motivación, lo que implica que los que tienen mejores habilidades de planificación y que son capaces de gestionar su motivación tienen mejor rendimiento académico. Conclusión: Las principales dimensiones que caracterizan la autorregulación del aprendizaje en estudiantes de medicina fueron: gestión del contexto, gestión de la cognición y evaluación de la comprensión.

Introduction: Self-regulation of learning refers to the modulation of affective, cognitive and behavioral processes throughout a learning experience to reach a desired level of achievement. Students who have a better management of their cognitive and metacognitive skills learn in a better way than those who do not, therefore, it is essential to study at what level university students are capable of learning to learn and to be managers of their learning. Objectives: To analyze the relationship between self-regulation of learning and academic performance in medical students from three universities in the year 2022. Materials and methods: This research followed a quantitative approach; the type of research was observational and descriptive. A previously validated instrument was used to identify types of self-regulation, the Self-Regulation of Learning from Texts (ARATEX-R). Results: No significant relationship was found between the academic profile of medical students and the total ARATEX-R score. When studying the relationship between the dimensions of self-regulation, a relationship was found between academic performance and motivation planning and management, which implies that those who have better planning skills and who are able to manage their motivation have better academic performance. Conclusion: The main dimensions that characterize the self-regulation of learning in medical students were: context management, cognition management and comprehension evaluation.

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Guatemala is a multiethnic and multicultural country that has suffered from poverty and violence. Sports can serve as tool to foster development across the country; however, there is limited research on the use of sports as a tool for promoting broader social benefits in Guatemala. The purpose of this study was to compare sports and the health and physiological characteristics of at-risk youths in Guatemala. The research objectives were achieved through a quantitative approach and the participation of 90 youths involved in an educational organization through sports and 91 youths who have not been influenced by any organization. The results showed that urban at-risk youths involved in a sports for education organization develop more self-esteem; they have higher levels of physical activity than their peers who are not involved in an educational organization; the socioemotional competencies of self-regulation and motivation are higher in urban areas; empathy is higher in men than in women; the level of the self-perception of health is lower and health literacy higher. However, the at-risk youths who are not involved in an educational organization showed that their self-regulation was higher, and the level of health literacy was higher for all factors. This was through a set of attitudes and skills as a result of their historical development and sociocultural strategies transmitted from generation to generation to foster health and physical activity.

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RESUMEN Introducción: En este estudio, se examinó la idoneidad de seleccionar atletas élite desde una edad temprana. Objetivo: El objetivo de este estudio consistió en verificar si el comportamiento identificado en investigaciones antecedentes también ocurre entre los mejores atletas mundiales de todos los tiempos que compiten en la carrera de 100 metros. Materiales y métodos: Para ello, y con base en un análisis de las clasificaciones oficiales de todos los tiempos masculinos y femeninos de la Asociación Internacional de Federaciones de atletismo en la referida prueba, se utilizó muestras en categoría absoluta (Top-1,000 hasta el 31/12/2018) y categoría sub-20 (Top-100 hasta el 31/12/2003); se aplicaron leyes de potencia y otras estrategias típicas de los sistemas complejos para analizar los datos. Resultados: los resultados muestran cómo, con demasiada frecuencia, los mejores corredores masculinos y femeninos del mundo en la categoría sub-20 no evolucionan positivamente durante el resto de su carrera deportiva mejorando sus registros en las categorías superiores. Solo 51 hombres de los 100 mejores corredores sub-20 de todos los tiempos, lograron mejorar sus registros una vez que alcanzaron la categoría sénior, y las mejoras no presentaron siempre progresiones estadísticamente significativas. En consecuencia, una inversión excesiva en recursos humanos y materiales para identificar individuos con altas capacidades atléticas, no es siempre la mejor estrategia. Conclusiones: el deporte de nivel a edades tempranas puede ser un error metodológico que debe evitarse a la hora de construir las reservas deportivas de un país o federación deportiva.

RESUMO Introdução: Neste estudo, examinou-se a adequação da seleção de atletas de elite desde tenra idade. Objetivo: O objetivo deste estudo foi verificar se o comportamento identificado em pesquisas anteriores também ocorre entre os melhores atletas do mundo de todos os tempos que competem na prova de 100 metros. Materiais e métodos: Para isso, e com base na análise das classificações oficiais de todos os tempos para homens e mulheres da Associação Internacional de Federações de Atletismo na prova supracitada, foram utilizadas amostras em categoria absoluta (Top-1.000 até 31/12 /2018) e sub-20 (Top-100 até 31/12/2003); Leis de potência e outras estratégias típicas de sistemas complexos foram aplicadas para analisar os dados. Resultados: Os resultados mostram como, muitas vezes, os melhores corredores masculinos e femininos do mundo na categoria sub-20 não evoluem positivamente durante o resto de sua carreira esportiva, melhorando seus registros nas categorias superiores. Apenas 51 homens dos 100 melhores corredores sub-20 de todos os tempos conseguiram melhorar seus tempos quando chegaram à categoria sênior, e as melhorias nem sempre mostraram progressões estatisticamente significativas. Consequentemente, um investimento excessivo em recursos humanos e materiais para identificar indivíduos com altas habilidades atléticas nem sempre é a melhor estratégia. Conclusões: o esporte de nível em idade precoce pode ser um erro metodológico que deve ser evitado na construção das reservas esportivas de um país ou federação esportiva.

ABSTRACT Introduction: In this study, the suitability of selecting elite athletes from an early age was examined. Objective: The objective of this study was to verify if the behavior identified in previous research also occurs among the world's best athletes of all time who compete in the 100-meter race. Materials and methods: For this, and based on an analysis of the official classifications of all times for men and women of the International Association of Athletics Federations in the referred test, samples were used in absolute category (Top-1,000 up to the 12/31/2018) and sub -20 category (Top - 100 until 12/31/2003); power laws and other strategies typical of complex systems will be applied to analyze the data. Results: The results show how, all too often, the best male and female runners in the world in the under-20 category do not evolve positively during the rest of their sports career. improving their records in the higher categories. Only 51 men out of the top 100 U-20 runners of all time managed to improve their times once they reached the senior category, and the improvements did not always show statistically significant progressions. Consequently, an excessive investment in human and material resources to identify individuals with high athletic abilities is not always the best strategy. Conclusions: level sport at an early age can be a methodological error that should be avoided when building the sports reserves of a country or sports federation.

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Aim: We analyze the impact of the COVID-19 pandemic on oncology service demand in a middle-income country with universal health coverage. Methods: We collected data from January 1st-2017 to December 31th-2021 at a reference center in Bogotá-Colombia regarding first-time consultations of cross-cutting services (clinical oncology, hematology, palliative care, radiation oncology); specialized multidisciplinary units (breast, prostate, lung, stomach); inpatient and outpatient systemic therapy; radiotherapy; oncology surgery; and bone marrow transplant. A descriptive time series analysis was performed, estimating monthly percent change and endemic channels. Results: Starting the confinement (April 2020), a general decrease in service demand was observed (R: -14.9% to -90.0%), with an additional but lower decrease in August 2020 coinciding with the first pandemic wave (R: -11.3% to -70.0%). Follow-up visits and ambulatory treatment showed no consistent reductions. New patients' consultations for cross-cutting services had a speedy recovery (1 month), but clinical oncology, specialized units, and in-hospital treatment resumed more slowly. Only breast and stomach cancer showed a sustained reduction in early-stage disease. Women and older patients had a more significant reductionin service demand. Conclusion: Despite no changes in service supply, the confinement induced a significant reduction in service demand. Variations by cancer type, service type, and population demographics deserve careful consideration for a suitable response to the emergency. The speedy recovery and the absence of a significant decrease during subsequent waves of the pandemic suggest patient resiliency and a lower impact than expected in middle-income settings in the presence of universal health insurance.

Objetivo: Analizar el impacto de la pandemia de COVID-19 sobre la demanda de servicios oncológicos. Metodos: Se recolectaron datos de enero 1/2017 hasta diciembre 31/2021 de consulta de primera vez en servicios transversales (oncología clinica, hematología, cuidados paliativos, oncología radioterápica) y servicios especializados multidisciplinarios (mama, próstata, pulmón, estómago), así como de suministro de tratamiento (terapia sistémica ambulatoria y hospitalaria, radioterapia, cirugía oncológica, trasplante de médula ósea), en un centro de referencia en Bogotá-Colombia. Se realizó un análisis descriptivo de series de tiempo estimando el cambio porcentual mensual y los canales endémicos. Resultados: Al inicio del confinamiento obligatorio (abril/2020) hubo una disminución general en la demanda de servicios transversales (R: -14.9% a -90.0%), con nuevo descenso de menor grado en agosto/2020 durante la primera ola de infecciones (R: -11.3% a -70.0%). Las consultas de seguimiento y tratamientos ambulatorios no mostraron reducciones consistentes. Exceptuando oncología clínica, las consultas de primera vez para servicios transversales tuvieron rápida recuperación hasta cifras basales (1 mes), pero las unidades especializadas y los tratamientos intrahospitalarios tuvieron recuperación mas lenta. Únicamente los cánceres de mama y estómago mostraron una reduccion sostenida de estadios tempranos de la enfermedad. La reducción de la demanda fue mas marcada en mujeres y adultos mayores. Conclusión: A pesar de no tener cambios en la oferta, el confinamiento indujo una reducción significativa en la demanda de servicios oncológicos con variación diferencial por tipo de cáncer, servicio y características demográficas de la población. Esto merece consideración especial para generar respuestas adecuadas a las emergencias sanitarias. La rápida recuperación de la demanda y la ausencia de caídas en olas de infección subsiguientes sugieren resiliencia de los pacientes e impacto menor del esperado en países con cobertura de salud universal.

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BACKGROUND: Anxiety is one of the most complex and the most studied constructs in psychology, and it is extremely frequent in high-level sportsmen and women. The main goal was to study the influence of sex, age, type of sport, sport modality, other professional occupation, and competitive level on the competitive anxiety symptoms and self-confidence of elite athletes. METHODS: A descriptive cross-sectional study was carried out with Colombian elite athletes who were members of the "Support to the Excellence Coldeportes Athlete" program. The total population studied included 334 Colombian elite athletes: mean age 27.10 ± 6.57 years old with 13.66 ± 6.37 years practicing his/her sports modality. The precompetitive anxiety symptoms of the participants were assessed using the Competitive State Anxiety Inventory-2R (CSAI-2R). RESULTS: Men showed higher levels of self-confidence than women. Younger athletes had a higher cognitive and somatic anxiety. The athletes of individual sports had a higher mean somatic anxiety than those of collective sports. The higher-level athletes had lower values of cognitive and somatic anxiety and higher levels of self-confidence. Finally, the values of anxiety symptoms positively correlated with each other, and negatively correlated with self-confidence. CONCLUSION: Individualised psychological intervention programs adapted to elite athletes are needed, considering the divergent results found in various variables of scientific interest.

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[This corrects the article DOI: 10.3389/fimmu.2017.00441.].

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Abstract Aim: We analyze the impact of the COVID-19 pandemic on oncology service demand in a middle-income country with universal health coverage. Methods: We collected data from January 1st-2017 to December 31th-2021 at a reference center in Bogotá-Colombia regarding first-time consultations of cross-cutting services (clinical oncology, hematology, palliative care, radiation oncology); specialized multidisciplinary units (breast, prostate, lung, stomach); inpatient and outpatient systemic therapy; radiotherapy; oncology surgery; and bone marrow transplant. A descriptive time series analysis was performed, estimating monthly percent change and endemic channels. Results: Starting the confinement (April 2020), a general decrease in service demand was observed (R: -14.9% to -90.0%), with an additional but lower decrease in August 2020 coinciding with the first pandemic wave (R: -11.3% to -70.0%). Follow-up visits and ambulatory treatment showed no consistent reductions. New patients' consultations for cross-cutting services had a speedy recovery (1 month), but clinical oncology, specialized units, and in-hospital treatment resumed more slowly. Only breast and stomach cancer showed a sustained reduction in early-stage disease. Women and older patients had a more significant reductionin service demand. Conclusion: Despite no changes in service supply, the confinement induced a significant reduction in service demand. Variations by cancer type, service type, and population demographics deserve careful consideration for a suitable response to the emergency. The speedy recovery and the absence of a significant decrease during subsequent waves of the pandemic suggest patient resiliency and a lower impact than expected in middle-income settings in the presence of universal health insurance.

Resumen Objetivo: Analizar el impacto de la pandemia de COVID-19 sobre la demanda de servicios oncológicos. Metodos: Se recolectaron datos de enero 1/2017 hasta diciembre 31/2021 de consulta de primera vez en servicios transversales (oncología clinica, hematología, cuidados paliativos, oncología radioterápica) y servicios especializados multidisciplinarios (mama, próstata, pulmón, estómago), así como de suministro de tratamiento (terapia sistémica ambulatoria y hospitalaria, radioterapia, cirugía oncológica, trasplante de médula ósea), en un centro de referencia en Bogotá-Colombia. Se realizó un análisis descriptivo de series de tiempo estimando el cambio porcentual mensual y los canales endémicos. Resultados: Al inicio del confinamiento obligatorio (abril/2020) hubo una disminución general en la demanda de servicios transversales (R: -14.9% a -90.0%), con nuevo descenso de menor grado en agosto/2020 durante la primera ola de infecciones (R: -11.3% a -70.0%). Las consultas de seguimiento y tratamientos ambulatorios no mostraron reducciones consistentes. Exceptuando oncología clínica, las consultas de primera vez para servicios transversales tuvieron rápida recuperación hasta cifras basales (1 mes), pero las unidades especializadas y los tratamientos intrahospitalarios tuvieron recuperación mas lenta. Únicamente los cánceres de mama y estómago mostraron una reduccion sostenida de estadios tempranos de la enfermedad. La reducción de la demanda fue mas marcada en mujeres y adultos mayores. Conclusión: A pesar de no tener cambios en la oferta, el confinamiento indujo una reducción significativa en la demanda de servicios oncológicos con variación diferencial por tipo de cáncer, servicio y características demográficas de la población. Esto merece consideración especial para generar respuestas adecuadas a las emergencias sanitarias. La rápida recuperación de la demanda y la ausencia de caídas en olas de infección subsiguientes sugieren resiliencia de los pacientes e impacto menor del esperado en países con cobertura de salud universal.

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Chimeric antigen receptor (CAR) T-cell therapy can induce durable remissions of relapsed/refractory B-acute lymphoblastic leukemia (ALL). However, case reports suggested differential outcomes mediated by leukemia cytogenetics. We identified children and young adults with relapsed/refractory CD19+ ALL/lymphoblastic lymphoma treated on 5 CD19-directed CAR T-cell (CTL019 or humanized CART19) clinical trials or with commercial tisagenlecleucel from April 2012 to April 2019. Patients were hierarchically categorized according to leukemia cytogenetics: High-risk lesions were defined as KMT2A (MLL) rearrangements, Philadelphia chromosome (Ph+), Ph-like, hypodiploidy, or TCF3/HLF; favorable as hyperdiploidy or ETV6/RUNX1; and intermediate as iAMP21, IKZF1 deletion, or TCF3/PBX1. Of 231 patients aged 1 to 29, 74 (32%) were categorized as high risk, 28 (12%) as intermediate, 43 (19%) as favorable, and 86 (37%) as uninformative. Overall complete remission rate was 94%, with no difference between strata. There was no difference in relapse-free survival (RFS; P = .8112), with 2-year RFS for the high-risk group of 63% (95% confidence interval [CI], 52-77). There was similarly no difference seen in overall survival (OS) (P = .5488), with 2-year OS for the high-risk group of 70% (95% CI, 60-82). For patients with KMT2A-rearranged infant ALL (n = 13), 2-year RFS was 67% (95% CI, 45-99), and OS was 62% (95% CI, 40-95), with multivariable analysis demonstrating no increased risk of relapse (hazard ratio, 0.70; 95% CI, 0.21-2.90; P = .7040) but a higher proportion of relapses associated with myeloid lineage switch and a 3.6-fold increased risk of all-cause death (95% CI, 1.04-12.75; P = .0434). CTL019/huCART19/tisagenlecleucel are effective at achieving durable remissions across cytogenetic categories. Relapsed/refractory patients with high-risk cytogenetics, including KMT2A-rearranged infant ALL, demonstrated high RFS and OS probabilities at 2 years.

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Resumen La glomerulonefritis posestreptocócica puede ser desencadenada por virus, bacterias hongos o parásitos, pues estos agentes son capaces de provocar una respuesta inflamatoria no controlada sobre el glomérulo y túbulo renal, en la cual participan la formación de inmunocomplejos y la activación de la vía alterna del complemento. Se han planteado múltiples mecanismos que involucran la generación de anticuerpos contra proteínas que hacen parte de la estructura del estreptococo y son conocidos como antígenos nefritogénicos, de los cuales los más estudiados recientemente son la exotoxina pirogénica B del estreptoco y la gliceraldehido-3-fosfato deshidrogenasa. Por su parte, la glomerulonefritis posestreptocócica suele tener un curso benigno con complicaciones que pueden ser controladas mediante manejo de soporte y es infrecuente en los adultos; sin embargo, en esta población tiene peor pronóstico que en los niños. Las lesiones proliferativas extracapilares son inusuales en la glomerulonefritis posestreptocócica. Se reporta el caso de un paciente adulto que presentó glomerulonefritis rápidamente progresiva secundaria a una infección por estreptococo.

Abstract: Post-infectious glomerulonephritis can be triggered by viruses, bacteria, fungi, or parasites. These agents can trigger an uncontrolled inflammatory response on the glomerulus and renal tubule, where the formation of immunocomplexes and the activation of the alternative complement pathway participate. Multiple mechanisms have been proposed that involve the generation of antibodies against proteins that are part of the structure of streptococcus and are known as nephrytogenic antigens of which the most recently studied are pyrogenic exotoxin B of streptococcus and glyceraldehyde 3 phosphate dehydrogenase. Post-streptococcal glomerulonephritis usually has a benign course with complications that can be controlled with supportive management. It is rare in adults, however, when it occurs, it has a worse prognosis compared to children. Extracapillary proliferative lesions are unusual in post-streptococcal glomerulonephritis. The case of an adult patient who debuted with rapidly progressive glomerulonephritis secondary to a strep infection is presented.

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Inefficient autologous tissue recovery in skin wounds increases the susceptibility of patients to infections caused by multidrug resistant microorganisms, resulting in a high mortality rate. Genetic modification of skin cells has become an important field of study because it could lead to the construction of more functional skin grafts, through the overexpression of antimicrobial peptides that would prevent early contamination and infection with bacteria. In this study, we produce and evaluate human skin equivalents (HSEs) containing transfected human primary fibroblasts and keratinocytes by polyplexes to express the antimicrobial peptide LL-37. The effect of LL-37 on the metabolic activity of normal HSEs was evaluated before the construction of the transfected HSEs, and the antimicrobial efficacy against Pseudomonas aeruginosa and Staphylococcus aureus was evaluated. Subsequently, the levels of LL-37 in the culture supernatants of transfected HSEs, as well as the local expression, were determined. It was found that LL-37 treatment significantly promoted the cellular proliferation of HSEs. Furthermore, HSEs that express elevated levels of LL-37 were shown to possess histological characteristics close to the normal skin and display enhanced antimicrobial activity against S. aureus in vitro. These findings demonstrate that HSEs expressing LL-37 through nonviral modification of skin cells are a promising approach for the prevention of bacterial colonization in wounds.

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RESUMEN La osteomielitis (OM) en el periodo neonatal es una condición rara y trascendental. Su incidencia estimada corresponde al 0,1 de casos por cada 100 admisiones hospitalarias. El subdiagnóstico es frecuente dada la presentación paucisintomática de este grupo etario, que lleva a demoras en el inicio del tratamiento y puede conducir a secuelas permanentes. Presentamos un caso de osteomielitis multifocal con fracturas asociadas, causada por la bacteria Staphylococcus aureus meticilina resistente (SAMR), secundaria a una infección asociada a catéter en un neonato nacido a las 37 semanas de gestación, con antecedente de asfixia perinatal y encefalopatía hipóxica isquémica. El caso debutó con sepsis, edema y artritis, pero el diagnóstico fue confirmado con ultrasonografía y radiografías que evidenciaron múltiples fracturas patológicas. Al no ser candidato para el manejo quirúrgico, se concertó una adecuación del esfuerzo terapéutico dirigiendo el manejo a la terapia antibiótica de amplio espectro y al control del dolor con adecuada respuesta clínica.

SUMMARY Osteomyelitis in the neonatal period is a rare but serious condition. Its estimated incidence corresponds to 0.1 case per 100 hospital admissions. Underdiagnosis is frequent given the paucisymtomatic presentation of this age group, leading to delays in the beginning of treatment and potential permanent sequelae. We present a case of osteomyelitis with associated fractures, caused by meticillin resistant Staphylococcus aureus secondary to catheterrelated bloodstream infection, in a term neonate with history of perinatal asphyxia and hipoxicischaemic encephalopathy. The newborn debuted with sepsis associated with edema and arthritis and the diagnosis was confirmed with ultrasonography and radiographs that showed multiple pathologic fractures. Not being a candidate for surgical management, the therapeutic effort was adapted, directing management to broadspectrum antibiotic therapy and pain control, with adequate clinical response.

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Resumen Comamonas kerstersii es un bacilo gramnegativo no fermentador, asociado a infecciones intraabdominales. Comunicamos un caso clínico de una bacteriemia por C. kerstersii en un joven con una apendicitis aguda. La primera identificación, mediante el sistema Vitek2 compact (BioMerieux) desde los hemocultivos, fue Comamonas testosteroni. Sin embargo, mediante MALDI-TOF se identificó como C. kerstersii. El paciente fue tratado con ampicilina/sulbactam y luego piperacilina/tazobactam con una evolución favorable. Dentro del género Comamonas, C. testosteroni ha sido la especie más frecuentemente reportada como causa de infecciones en humanos, describiéndose solo 23 casos de C. kerstersii. Dado los problemas en la identificación fenotípica de estos microorganismos, es posible que algunos de los reportes de C. testosteroni pudieran haber correspondido a C. kerstersii. Este caso pone en evidencia el rol patógeno de C. kerstersii y la importancia de utilizar MALDI-TOF como herramienta diagnóstica en bacilos gramnegativos no fermentadores.

Abstract Comamonas kerstersii is a non-fermenting Gram-negative bacillus. It has been associated with intra-abdominal infections. We describe a clinical case of bacteremia caused by C. kerstersii in a young man with acute appendicitis. The first identification, using the Vitek2 compact system (BioMerieux) from blood cultures, was Comamonas testosteroni. However, using MALDI-TOF was identified as C. kerstersii. The patient was treated first with ampicillin sulbactam and then piperacillin tazobactam with favorable evolution. Within the genus Comamonas, C. testosteroni has been the most frequently reported species as a cause of infections in humans, only 23 cases of C. kerstersii being described. Given the problems of phenotypic identification of these microorganisms, it is possible that some C. testosteroni reports could have corresponded to C. kerstersii. This case highlights the pathogenic role of C. kerstersii and the importance of using MALDI-TOF as a diagnostic tool for non-fermenting Gram-negative bacilli identification.

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Introducción: la rinosinusitis crónica (RSC) es una de las enfermedades más prevalentes a nivel mundial. Los eosinófilos desempeñan un papel importante en la generación del proceso inflamatorio nasosinusal crónico secundario a la generación de una respuesta maladaptativa Th2 y cambios en la microbiota nasal. El objetivo del estudio es determinar si la eosinofilia periférica puede usarse como factor predictor de severidad tomográfica en pacientes que cursan con rinosinusitis crónica. Métodos: se realizó un estudio observacional de corte transversal con componente analítico en pacientes con diagnóstico de RSC quienes dispusieran en su registro de historia clínica un hemograma con recuento de eosinófilos. El tamaño de la muestra fue de 74 individuos. Resultados: la eosinofilia periférica se estableció como factor de severidad tomográfica, ya que se encontró que por cada incremento de 100 eosinófilos en sangre, aumentaría en un punto el puntaje total de la escala tomográfica Lund-Mackay. Este patrón fue similar en pacientes con pólipos y asma, en los que se encontró un incremento en los puntajes totales de 4 y 5 puntos, respectivamente, con respecto a los pacientes que no presentan estas patologías. Conclusión: la utilización de la eosinofilia periférica como predictor de severidad podría ser de gran utilidad para la comunidad médica. Este biomarcador puede resultar en un ahorro potencial de costos al eliminar la necesidad de tratamientos médicos repetidos en pacientes que de entrada tienen un riesgo incrementado de enfermedad nasosinusal severa.

Introduction: chronic rhinosinusitis (CRS) is one of the most prevalent diseases worldwide. Eosinophils play an important role in the generation of a chronic nasosinusal inflammatory process secondary to the generation of a Th2 maladaptive response and changes in the nasal microbiota. The objective of the study is to determine if peripheral eosinophilia can be used as a predictor of tomographic severity in patients with chronic rhinosinusitis. Methods: an observational cross-sectional study with an analytical component was performed in patients with a diagnosis of CSR who had an eosinophil count in their clinical record. The sample size was 74 individuals. Results: peripheral eosinophilia was established as a tomographic severity factor, finding that for each increase of 100 eosinophils in blood, the total score of the Lund-Mackay tomographic scale would increase by 1 point. This pattern was equally concordant in patients with polyps and asthma, with increases in total scores of 4 and 5 points respectively, with respect to patients who do not present these pathologies. Conclusion: the uses of peripheral eosinophilia as a predictor of severity could be very useful for the medical community. This biomarker can result in potential cost savings by eliminating the need for repeated medical treatments in patients who initially have an increased risk of severe nasosinusal disease.

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La neumonía adquirida en la comunidad en adultos, es un importante problema de salud pública. En América Latina son muy escasas las publicaciones que documenten su incidencia. Esta comunicación breve proporciona datos preliminares sobre la incidencia (105 persona/año) de neumonías en adultos hospitalizados. La base de datos de una institución médica privada de Uruguay, posibilitó la estimación de la incidencia de esa patología, antes de la implementación de la vacuna conjugada neumocóccica (VCN) en la infancia y luego de su aplicación. En 1.688 pacientes con neumonía los mayores de 64 años predominaron y su incidencia fue de 1.938 en el período prevacunación, descendiendo significativamente a 1.365 luego de la VCN. A pesar de la posible protección indirecta de la vacunación, la información presentada alerta sobre la persistencia de morbimortalidad por neumonía en adultos mayores.

Pneumonia in adults poses severe health risks, but data on its burden still lacks in Latin American countries including Uruguay. To fill this gap preliminary information on hospitalized pneumonia incidence in adults was analyzed. A data base from a private medical institution enabled to estimate, pre and post pneumococcal conjugate vaccine incidences (105 person/year), by age groups. Out of 1 688 adults hospitalized due to pneumonia, the group aged >64 yers predominated. For the same age group, a significant difference (1.938 vs. 1.365) was observed on incidences before and after conjugate vaccine application in children. Although more robust information on adult pneumonia hospitalizations are required to confirm indirect vaccine effect, these data alert on pneumonia persistence which requires preventive measures.

A pneumonia adquirida na comunidade em adultos é um grande problema de saúde pública. Na América Latina existem muito poucas publicações que documentam sua incidência. Esta breve comunicação fornece dados preliminares sobre a incidência (105 pessoas / ano) de pneumonias em adultos hospitalizados. O banco de dados de uma instituição médica privada no Uruguai possibilitou estimar a incidência dessa patologia, antes da implementação da vacina conjugada pneumocócica (VCN) na infância e após sua aplicação. Em 1.688 pacientes com pneumonia, aqueles com mais de 64 anos de idade predominaram e sua incidência foi de 1.938 no período de pré-vacinação, descendo significativamente para 1.365 após a VCN. Apesar da possível proteção indireta da vacinação, as informações apresentadas alertam sobre a persistência da morbimortalidade por pneumonia em idosos.

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The purpose of this study was to assess the veracity of the Court of Arbitration for Sport's assertion that sex-differences in athletic performance in elite-standard track and field competition is of the order of 10-12%. Exponential curves were fitted to the data of selected track and field events of the finals of all IAAF World Championships and Olympic Games from 1983 to 2016. For each curve, the coefficient of determination R2 was calculated, in combination the corresponding 95% confidence intervals for the curve constants. Sex-differences were evaluated via differences in the fitted curves between men and women. Mean performances of winners, as well as overall performance means of all participants, were also analyzed. The calculated sex-difference was 8.2 ± 1.0% - 11.8 ± 2.1% for sprints, 10.3 ± 3.3% - 12.8 ± 4.0% for middle and long-distance events, 9.7 ± 2.9% - 13.1 ± 2.9% for relays and 14.2 ± 2.2% - 25.0 ± 4.4% for jumps. This study therefore confirms that the percentage difference accepted by the CAS is appropriate for elite-standard track and field events.

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Acinetobacter baumannii is the etiologic agent of a wide range of nosocomial infections, including pneumonia, bacteremia, and skin infections. Over the last 45 years, an alarming increase in the antibiotic resistance of this opportunistic microorganism has been reported, a situation that hinders effective treatments. In order to develop effective therapies against A. baumannii it is crucial to understand the basis of host-bacterium interactions, especially those concerning the immune response of the host. Different innate immune cells such as monocytes, macrophages, dendritic cells, and natural killer cells have been identified as important effectors in the defense against A. baumannii; among them, neutrophils represent a key immune cell indispensable for the control of the infection. Several immune strategies to combat A. baumannii have been identified such as recognition of the bacteria by immune cells through pattern recognition receptors, specifically toll-like receptors, which trigger bactericidal mechanisms including oxidative burst and cytokine and chemokine production to amplify the immune response against the pathogen. However, a complete picture of the protective immune strategies activated by this bacteria and its potential therapeutic use remains to be determined and explored.