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Peroxiredoxins (Prxs) and glutathione peroxidases (GPxs) are the main enzymes of the thiol-dependent antioxidant systems responsible for reducing the H2O2 produced via aerobic metabolism or parasitic organisms by the host organism. These antioxidant systems maintain a proper redox state in cells. The cysticerci of Taenia crassiceps tolerate millimolar concentrations of this oxidant. To understand the role played by Prxs in this cestode, two genes for Prxs, identified in the genome of Taenia solium (TsPrx1 and TsPrx3), were cloned. The sequence of the proteins suggests that both isoforms belong to the class of typical Prxs 2-Cys. In addition, TsPrx3 harbors a mitochondrial localization signal peptide and two motifs (-GGLG- and -YP-) associated with overoxidation. Our kinetic characterization assigns them as thioredoxin peroxidases (TPxs). While TsPrx1 and TsPrx3 exhibit the same catalytic efficiency, thioredoxin-glutathione reductase from T. crassiceps (TcTGR) was five and eight times higher. Additionally, the latter demonstrated a lower affinity (>30-fold) for H2O2 in comparison with TsPrx1 and TsPrx3. The TcTGR contains a Sec residue in its C-terminal, which confers additional peroxidase activity. The aforementioned aspect implies that TsPrx1 and TsPrx3 are catalytically active at low H2O2 concentrations, and the TcTGR acts at high H2O2 concentrations. These results may explain why the T. crassiceps cysticerci can tolerate high H2O2 concentrations.

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BACKGROUND: Knowledge about the influence of early developmental factors on cardiometabolic health in the Maya is limited. AIM: To analyse the relationship between birthweight (BW) and cardiometabolic parameters in a sample of rural Maya children from Yucatan, Mexico. SUBJECTS AND METHODS: We took anthropometric measurements and obtained data on BW and fasting blood samples in a sample of 75 children aged 5-14 years. Dependent variables were: fat mass index (FMI), body mass index (BMI), glucose (G), triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), LDL/HDL and TC/HDL ratios and metabolic index (TGxG/HDL2). Outcomes were transformed to y = 100 log(e)x and the resulting estimates are interpreted as symmetrical percentage differences. The main independent variable was BW z-score. Multiple linear regression analyses were used to assess the relationship between BW and outcomes. RESULTS: An increase of one standard deviation in BW predicted 6.6% (95% CI [-11.6, -1.6]) decrease in HDL and 11% (95% CI [3.7, 18.4]), 7.8% (95% CI [2.3, 13.2]) and 19.6% (95% CI [3.1, 36]) increases in LDL/HDL, TC/HDL and metabolic index, respectively. CONCLUSION: Higher birthweights were associated with adverse levels of biochemical parameters in this sample of rural Maya children.

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OBJECTIVE: To analyze changes in height, weight, and body mass index (BMI = kg/m2 ) from 1986 to 2022 in 3-11 year old children from Dzeal, a rural Maya community in Yucatan, Mexico. MATERIALS AND METHODS: From October-2022 to February-2023 (third-wave survey), we obtained anthropometric measurements of children (n = 80) and family socioeconomic data and compared them with data obtained in 1986 (n = 38) and 2000 (n = 76). Comparisons of anthropometric parameters by sex between years of measurement were performed graphically and through one-way ANOVA, splitting children into two age groups: 3-7 and 8-11. Bonferroni adjustments for multiple comparisons were used when ANOVAs were statistically significant (p < .05). RESULTS: In girls, significant increases in height and weight between surveys were found in 3-7 and 8-11 age groups; in boys, significant increases were only found in the 8-11 age group. Regarding BMI, there were increases in 2022 compared with 1986/2000 in both sexes from 8 years onwards. Differences indicate increases of 3.9 and 4.4 cm per decade in girls aged 3-7 and 8-11, respectively, and increases in weight of 1.1 and 3.3 kg per decade, respectively. Increases in boys 8-11 years were 2.3 cm and 2.4 kg per decade. CONCLUSION: Significant increases in growth parameters were observed in specific-age children in the community studied in the context of changes in livelihoods and improvements in household material conditions.

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Thirty-four species of Triatominae (Hemiptera, Reduviidae) are recorded in Mexico, Triatoma Laporte, 1832 the most speciose genus in this country. Here, we describe Triatoma yelapensis sp. nov. from the Pacific coast of Jalisco (Mexico). The most similar species to T. yelapensis sp. nov. is T. recurva (Stål, 1868), but they differ in head longitude, the proportion of labial segments, coloration pattern of corium and connexivum, spiracles location, and male genitalia. To provide statistical support for the morphological distinctiveness of the new species, we performed a geometric morphometric analysis of T. yelapensis sp. nov., T. dimidiata s.s. (Latreille, 1811), T. gerstaeckeri (Stål, 1859), and T. recurva (Stål, 1868), considering head morphology. We also provide an updated key of the genus Triatoma for species recorded in Mexico.

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OBJECTIVE: To analyze the impact of COVID-19 on the number of births in Yucatan, Mexico during 2020 and 2021. MATERIAL AND METHODS: A total of 470 651 live births occurred in Yucatan from January 1st, 2008, to December 31st, 2021, and were included in the analysis. The monthly number of births observed during January 2008-February 2020 was used to describe pre-pandemic trends. Time-series analysis was applied to examine whether the number of births observed from December 2020 (9 months after the beginning of the pandemic) to December 2021 differed from the expected values. Trends in the number of births according to maternal age, parity and education were examined to identify changes differentiated by sociodemographic characteristics. RESULTS: The number of births in 2021 decreased by 18% (5869 births) compared with 2019, which represents a reduction from 12.89 to 12.48 per thousand inhabitants. The observed number of births from December 2020 to July 2021 was significantly lower than the figure expected. April (expected = 2863 vs. observed = 1722), May (expected = 2948 vs. observed = 1990), and June (expected = 2997 vs. observed = 1978) 2021 showed the largest differences between expected and observed values. Then, from August to December 2021, the observed number of births fell within the expected range. Birth decline was slightly more pronounced among mothers between 20 and 29 years of age and in those without previous offspring. CONCLUSION: We provide evidence of birth decline in Yucatan during the COVID-19 pandemic. Birth rate reduction in Yucatan doubled the world average and young women without children were the most affected.

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INTRODUCTION: Data on extra-corporeal membrane oxygenation (ECMO) therapy for pregnant patients with Coronavirus 2019 (COVID-19) infection are limited. Here we report a case of an emergency cesarean section performed while the COVID-19 positive mother was on ECMO support. CASE REPORT: A 36-year-old COVID-19 positive patient at 26 weeks gestational age presented with respiratory failure requiring extra-corporeal membrane oxygenation therapy. Nine days later fetal distress demanded an emergency C-section. After 5 weeks on ECMO, the patient was weaned off. Both mother and child were discharged. DISCUSSION: The decision to perform an urgent C-section is one that requires meticulous thought from the attending team. Pulmonary maturation is key as pregnancy may need to be terminated at any time during ECMO. CONCLUSION: Data on ECMO support for pregnant patients with COVID-19 infection are scarce. Best results can be achieved ensuring adequate anticoagulation, meticulous choice of cannulas, continued fetal monitoring, early lung maturation, and precision timing of delivery.

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MitraClip implantation has been reported in severe mitral regurgitation following ischemic papillary muscle rupture in surgically high-risk patients with cardiogenic shock. Here we present a case of a 68-year-old female patient who suffered an ischemic papillary muscle rupture resulting in severe mitral prolapse and had a MitraClip implanted. Three months later, due to progressive symptoms, she was taken to surgery and had an elective minimally invasive mitral valve replacement. Informed consent was given and ethics board approval was obtained.

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Single-ventricular cardiopathies are challenging conditions requiring multiple surgical interventions to hopefully achieve adulthood. In neonates, pulmonary artery banding allows ventricular adaptation and pulmonary vascular bed protection. Here we present a novel minimally invasive approach to pulmonary artery banding through a 1.5 cm left parasternal minithoracotomy. This technique not only allows for a less traumatic first procedure but also a less manipulated mediastinum and untouched sternum for the consequent surgeries to come. This technique is reproducible in experienced hands and shows favorable and promising results when performed properly.

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Objetivo: Describir la diversidad dietética (DD) de un grupo de mujeres embarazadas del municipio de Mérida, Yucatán. Métodos: Se aplicó un cuestionario socioeconómico y tres recordatorios de 24 horas (R-24) en días no consecutivos a 83 mujeres embarazadas. La DD se evaluó a nivel individual de acuerdo a la puntuación Mínima de Diversidad Dietética para la Mujer (MDD-W). Se consideró una DD alta cuando se consumieron ≥5 grupos de alimentos y DD baja cuando el consumo fue <5. Se analizaron las diferencias en el consumo de los grupos de alimentos de acuerdo al nivel de DD mediante pruebas de Chi2. Resultados: La edad promedio de la muestra fue de 27,6 años (±5,2), con una edad gestacional promedio de 23 semanas (±8,3). La media de la DD fue de 4,9 (±1,5) grupos de alimentos. El 39% de la muestra tuvo una DD baja. Las mujeres con DD baja consumieron en menor frecuencia alimentos cárnicos, huevos, vegetales de hoja verde oscuro, frutas y verduras ricas en vitamina A, otras verduras y otras frutas (P= <0,05). La proporción de mujeres con DD baja fue mayor durante los fines de semana (49% vs 68%, Chi2= 7,89, P= 0,005). Conclusiones: La media de la DD obtenida en esta muestra indica una DD baja. Las mujeres en este estudio presentaron un bajo consumo de alimentos ricos en vitaminas mientras que los alimentos ricos en energía y proteína de origen animal presentan un consumo alto.

Objective: To describe the dietary diversity (DD) in a sample of pregnant women from Merida, Yucatan. Methods: We applied a socioeconomic questionnaire and three 24-h dietary recalls, on non-consecutive days, to 83 pregnant women residing in Merida, Yucatan. DD was assessed according to the Minimum Dietary Diversity score for Women (MDD-W). A high DD was considered when a consumption ≥5 food groups occurred, while a consumption <5 groups was considered as a low DD. We analyze the differences in the consumption of food groups according to the level of DD. Chi square test were applied to assess DD. Results: The mean age of participants was 27.6 years (±5.2) and the average gestational age was 23 weeks (±8.3). The mean DD was 4.9 (±1.5) food groups and 39% of the sample had a low DD. Women with low DD consumed less frequently meat foods, eggs, dark green leafy vegetables, fruits and vegetables rich in vitamin A, other vegetables and other fruits (P<=0.05). Low DD was more frequently registered during weekend days (49% vs 68%, P= 0.005). Conclusions: The sample had low DD. Women who participated in this study had a low consumption of foods rich in micronutrients while foods rich in energy and protein of animal origin had a high consumption.

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MitraClip implantation has been reported in severe mitral regurgitation following ischemic papillary muscle rupture in surgically high-risk patients with cardiogenic shock. Here we present a case of a 68-year-old female patient who suffered an ischemic papillary muscle rupture resulting in severe mitral prolapse and had a MitraClip implanted. Three months later, due to progressive symptoms, she was taken to surgery and had an elective minimally invasive mitral valve replacement. Informed consent was given and ethics board approval was obtained.

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Colorectal Cancer (CRC) ranks third in terms of incidence and second in terms of mortality and prevalence worldwide. In relation to chemotherapy treatment, the most used drug is 5-fluorouracil (5-FU); however, the use of this drug generates various toxic effects at the systemic level. For this reason, new therapeutic strategies are currently being sought that can be used as neoadjuvant or adjuvant treatments. Recent research has shown that natural compounds, such as genistein, have chemotherapeutic and anticancer effects, but the mechanisms of action of genistein and its molecular targets in human colon cells have not been fully elucidated. The results reported in relation to non-malignant cell lines are also unclear, which does not allow evidence of the selectivity that this compound may have. Therefore, in this work, genistein was evaluated in vitro in both cancer cell lines SW480 and SW620 and in the non-malignant cell line HaCaT. The results obtained show that genistein has selectivity for the SW480 and SW620 cell lines. In addition, it inhibits cell viability and has an antiproliferative effect in a dose-dependent manner. Increased production of reactive oxygen species (ROS) was also found, suggesting an association with the cell death process through various mechanisms. Finally, the encapsulation strategy that was proposed made it possible to demonstrate that bacterial nanocellulose (BNC) is capable of protecting genistein from the acidic conditions of gastric fluid and also allows the release of the compound in the colonic fluid. This would allow genistein to act locally in the mucosa of the colon where the first stages of CRC occur.

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Seven styrylquinolines were synthesized in this study. Two of these styrylquinolines are new and were elucidated by spectroscopic analysis. The chemopreventive potential of these compounds was evaluated against SW480 human colon adenocarcinoma cells, its metastatic derivative SW620, and normal cells (HaCaT). According to the results, compounds 3a and 3d showed antiproliferative activity in SW480 and SW620 cells, but their effect seemed to be caused by different mechanisms of action. Compound 3a induced apoptosis independent of ROS production, as evidenced by increased levels of caspase 3, and had an immunomodulatory effect, positively regulating the production of different immunological markers in malignant cell lines. In contrast, compound 3d generated a pro-oxidant response and inhibited the growth of cancer cells, probably by another type of cell death other than apoptosis. Molecular docking studies indicated that the most active compound, 3a, could efficiently bind to the proapoptotic human caspases-3 protein, a result that could provide valuable information on the biochemical mechanism for the in vitro cytotoxic response of this compound in SW620 colon carcinoma cell lines. The obtained results suggest that these compounds have chemopreventive potential against CRC, but more studies should be carried out to elucidate the molecular mechanisms of action of each of them in depth.

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Introducción: La hipertensión arterial es una de las enfermedades con mayor preva-lencia en nuestro país. La prescripción de antagonistas del receptor de angiotensina tipo II, es uno los tratamientos más comunes; sin embargo, su dosis máxima efectiva es controversial. Objetivo: El objetivo del estudio fue caracterizar una población de una entidad promotora de salud en Colombia, que recibía para el manejo de la hipertensión arterial, una dosis de losartán mayor a 100 mg/día. Metodología: Se incluyó una base de prescripción de 3816 casos con hipertensión arterial, en manejo con losartán potásico a dosis superiores a 100 mg/día, con una muestra proporcional de 300 casos; en quienes se aplicó una alerta de dosis máxima (100 mg/día) en la prescripción. Se describió el perfil farmacoterapéutico, interacciones farmacológicas, cambios de dosificación y en las cifras de presión arterial. Para confirmar el efecto terapéutico de losartán potásico en control de cifras de presión arterial, se realizaron pruebas estadísticas (Tukey, Bonferroni). Resultados: De los 300 pacientes, 224 (74,6%) contaban con registro de presión arterial al inicio de la prescripción de losartán potásico a 100 mg/día; después de la intervención se logró reducción de dosis en 70 casos (23,3%). 76 casos (25,3%) no contaban con ningún paraclínico de seguimiento. Conclusión: No se encontró evidencia clínica o científica que justifique la prescripción de losartán con dosis mayores a 100 mg/día para el manejo de la hipertensión arterial esencial en nuestra población descrita.

SUMMARY Introduction: Hypertension is one of the most prevalent diseases in our country. Type II angiotensin receptor antagonists are one of the most common treatments; however, its maximum effective dose is controversial. Aim: The objective of study to characterize a population of a health promoting entity in Colombia, which received a dose of losartan greater than 100 mg/day for management of arterial hypertension. Methodology: The study included a prescription base of 3816 cases with arterial hypertension, in management with losartan potassium at doses higher than 100 mg/day, with a proportional sample of 300 cases; in whom a maximum dose alert (100 mg/day) was applied in prescription. Pharmacotherapeutic profile, drug interactions, dosage changes, and changes in blood pressure figures were described. To confirm therapeutic effect of losartan potassium in controlling blood pressure figures, statistical tests were performed (Tukey, Bonferroni). Results: Of the 300 patients, 224 (74.6%) had a blood pressure record at beginning of prescription of losartan potassium at 100 mg/day; after the intervention, a dose reduction was achieved in 70 cases (23.3%). 76 cases (25.3%) did not have any follow-up paraclinical. Conclusion: It was concluded that losartan potassium at doses greater than 100 mg/day did not show statistically significant differences for blood pressure control. We found insufficient clinical and scientific evidence to support the treatment with losartan more than 100 mg/day for hypertension in our population.

Introdução: A hipertensão arterial é uma das doenças mais prevalentes em nosso país. Os antagonistas do receptor de angiotensina tipo II são um dos tratamentos mais comuns; entretanto, sua dose máxima efetiva é controversa. Objetivo: Caracterizar uma população de uma entidade promotora de saúde na Colômbia, que receberam uma dose de losartana superior a 100 mg/dia para tratamento de hipertensão. Metodologia: O estudo incluiu uma base de prescrição de 3816 casos com hipertensão arterial, em manejo com losartana potássica em doses maiores superior a 100 mg/ dia, com amostra proporcional de 300 casos; em quem um máximo alerta de dose (100 mg/dia) foi aplicado na prescrição. Perfil farmacoterapêutico, interações medicamentosas, alterações de dosagem e alterações nos valores da pressão arterial foram descrito. Para confirmar o efeito terapêutico da losartana potássica no controle do sangue valores pressóricos, foram realizados testes estatísticos (Tukey, Bonferroni). Resultados: De dos 300 pacientes, 224 (74,6 %) tinham registro de pressão arterial no início da prescrição de losartana potássica a 100 mg/dia; após a intervenção, uma redução da dose foi alcançada em 70 casos (23,3 %). 76 casos (25,3 %) não tiveram seguimento paraclínico. Conclusão: Concluiuse que a losartana potássica em doses maiores superior a 100 mg/dia não apresentou diferenças estatisticamente significativas para a pressão arterial ao controle. Encontramos evidências clínicas e científicas insuficientes para apoiar o tratamento com losartana mais de 100 mg/dia para hipertensão em nossa população.

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Curcumin, a curcuminoid present in the rhizome of the plant Curcuma longa has multiple pharmacological effects including anticarcinogenic and anti-inflammatory properties. This work evaluates the anthelmintic effect of the curcumin molecule (98% pure) on Taenia crassiceps cysticerci viability in vitro. Cysticerci incubated in the presence of increasing concentrations of curcumin showed a dose-dependent mortality correlated with a significant increase in the production of reactive oxygen species and a partial inhibition of thioredoxin-glutathione reductase, the only disulfide reductase present in these parasites. At 500 µM curcumin, a 100% of cysticerci lethality was obtained after 2 h of treatment. These results suggest the curcumin-induced oxidative stress could be in the origin of the anthelminthic effect of curcumin. Mice with cysticerci were injected intraperitoneally with 20, 40, or 60 mM curcumin daily for 30 days. A decrease in the burden of cysticerci (46%) was observed with a 60 mM dose of curcumin, supporting this compound as a potential anthelmintic drug.

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Critical donor shortages have impulsed the need to expand donor heart eligibility through the use of marginal hearts in cardiac transplantation. Donor valvular disease has been considered as an absolute contraindication for transplant. A 39-year-old male patient with end-stage non-compaction cardiomyopathy, an INTERMACS II heart failure, and a left ventricular ejection fraction of 8% was taken to an orthotopic heart transplantation. During donor bench graft examination, a congenital bicuspid and calcified aortic valve was found. The native bicuspid valve was removed and the annular calcification debrided; a #21 bioprosthetic aortic valve was then implanted.

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In the field of cardiovascular surgery, many areas are frequently evaluated to improve patient outcomes. Even though cardiac surgery has advanced significantly, peri-operative nutrition remains an area needing special attention and is under-considered in patient results. The three portions of cardiac surgical nutrition optimization are pre-operative, intra-operative and post-operative. All these, merit important clinical intervention which when done properly can significantly improve patient recovery and reduce morbidity and mortality. Here we provide a narrative review and recommendations for peri-operative nutritional optimization in cardiac surgery.

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RESUMEN Introducción: el principal patógeno en las infecciones osteoarticulares es el Staphylococcus aureus, los esquemas de tratamiento recomendados se basan en la literatura estadounidense o europea, no hay datos de estudios locales. El propósito de este estudio es conocer el perfil epidemiológico en las infecciones osteoarticulares del Hospital Infantil San Vicente Fundación (Medellín, Colombia) y las características de los pacientes afectados. Materiales y métodos: revisión retrospectiva de historias de pacientes entre los 0 y 15 años con diagnóstico de infección osteoarticular en el Hospital Infantil San Vicente Fundación, se detallaron las variables demográficas de la patología y los antecedentes relevantes para caracterizar el perfil epidemiológico de las infecciones osteoarticulares. Resultados: identificamos 72 pacientes con infección osteoarticular. La infección más común fue la artritis séptica (40 %), seguida por la osteomielitis aguda (37 %). La cadera (18 %) y la tibia (31 %) fueron la articulación y el hueso afectados con mayor frecuencia. La mayoría de las infecciones fueron secundarias a S. aureus (65 %), de estas fueron por Stafilococo aureus meticilino sensible (SAMS) el 38,9 % y por Stafilococo aureus meticilino resistente (SAMR)el 26,4 %. El tratamiento antibiótico empírico y el tratamiento definitivo se basó en cefalosporinas de primera generación en 83 % y 52,7% de los casos, respectivamente. La principal complicación fue la sepsis en 18 (25 %) pacientes. Conclusiones: se debe tener un alto índice de sospecha, no todos los pacientes se presentan con síntomas o signos típicos. El patógeno principal es el Staphylococcus aureus. En los últimos 10 años ha aumentado la incidencia de las infecciones por SAMR en nuestra institución en relación con estudios previos. Notamos una demora en el diagnóstico y, por ende, en el inicio del tratamiento.

SUMMARY Introduction: The main pathogen in osteoarticular infections is Staphylococcus aureus. The recommended treatment schemes are based on American or European literature, there are no data from local studies. The purpose of this study is to know the epidemiological profile in osteoarticular infections of the San Vicente Fundación children's hospital (Medellín/Colombia) and the characteristics of the affected patients. Materials and methods: Retrospective review of histories of patients between 0 and 15 years old with a diagnosis of osteoarticular infection in the San Vicente Fundación children's hospital detailing demographic variables, pathology and relevant antecedents to characterize the epidemiological profile of osteoarticular infections in the hospital. Results: We identified 72 patients with osteoarticular infection. The most common septic arthritis infection (40%) followed by acute osteomyelitis (37%), the most affected joint was the hip (18%) and the most affected bone was the tibia (31%). The majority of infections were secondary to S. aureus (65%) of which were by SAMS 38.9% and by SAMR 26.4%. Empirical as well as definitive antibiotic treatment was based on first generation cephalosporins 83% and 52.7% respectively. The main complication was sepsis in 18 (25%) patients. Conclusions: There must be a high index of suspicion, not all patients present with typical symptoms and / or signs. The main pathogen Staphylococcus aureushas increased the incidence of MRSA infections in our institution in the last 10 years in relation to previous studies. We note delay in diagnosis and therefore in the start of treatments.

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In elderly (75 years or older) patients living in Latin America with severe symptomatic aortic stenosis candidates for transfemoral approach, the panel suggests the use of transcatheter aortic valve implant (TAVI) over surgical aortic valve replacement (SAVR). This is a conditional recommendation, based on moderate certainty in the evidence. This recommendation does not apply to patients in which there is a standard of care, like TAVI for patients at very high risk for cardiac surgery or inoperable patients, or SAVR for non-elderly patients (eg, under 65 years old) at low risk for cardiac surgery. The suggested age threshold of 75 years old is based on judgement of limited available literature and should be used as a guide rather than a determinant threshold. The conditional nature of this recommendation means that the majority of patients in this situation would want a transfemoral TAVI over SAVR, but some may prefer SAVR. For clinicians, this means that they must be familiar with the evidence supporting this recommendation and help each patient to arrive at a management decision integrating a multidisciplinary team discussion (Heart Team), patient's values and preferences through shared decision-making, and available resources. Policymakers will require substantial debate and the involvement of various stakeholders to implement this recommendation.

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