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  • Endoscopic ultrasound-guided injection of coils for the treatment of refractory post-ERCP bleeding

    Guzmán-Calderón, Edson; Ruiz, Francisco; Casellas, Juan Antonio; Martinez-Sempere, Juan; Medina-Prado, Lucía; Aparicio, Jose R. (Georg Thieme Verlag, 2020-08-01)
    No presenta resumen.
    Acceso abierto
  • Association of statin use and clinical outcomes in heart failure patients: A systematic review and meta-analysis

    Bielecka-Dabrowa, Agata; Bytyçi, Ibadete; Von Haehling, Stephan; Anker, Stefan; Jozwiak, Jacek; Rysz, Jacek; Hernandez, Adrian V.; Bajraktari, Gani; Mikhalidis, Dimitri P.; Banach, Maciej (BioMed Central Ltd, 2019-10-31)
    Background The role of statins in patients with heart failure (HF) of different levels of left ventricular ejection fraction (LVEF) remains unclear especially in the light of the absence of prospective data from randomized controlled trials (RCTs) in non-ischemic HF, and taking into account potential statins’ prosarcopenic effects. We assessed the association of statin use with clinical outcomes in patients with HF. Methods We searched PubMed, EMBASE, Scopus, Google Scholar and Cochrane Central until August 2018 for RCTs and prospective cohorts comparing clinical outcomes with statin vs non-statin use in patients with HF at different LVEF levels. We followed the guidelines of the 2009 PRISMA statement for reporting and applied independent extraction by multiple observers. Meta-analyses of hazard ratios (HRs) of effects of statins on clinical outcomes used generic inverse variance method and random model effects. Clinical outcomes were all-cause mortality, cardiovascular (CV) mortality and CV hospitalization. Results Finally we included 17 studies (n = 88,100; 2 RCTs and 15 cohorts) comparing statin vs non-statin users (mean follow-up 36 months). Compared with non-statin use, statin use was associated with lower risk of all-cause mortality (HR 0.77, 95% confidence interval [CI], 0.72–0.83, P < 0.0001, I2 = 63%), CV mortality (HR 0.82, 95% CI: 0.76–0.88, P < 0.0001, I2 = 63%), and CV hospitalization (HR 0.78, 95% CI: 0.69–0.89, P = 0.0003, I2 = 36%). All-cause mortality was reduced on statin therapy in HF with both EF < 40% and ≥ 40% (HR: 0.77, 95% Cl: 0.68–0.86, P < 0.00001, and HR 0.75, 95% CI: 0.69–0.82, P < 0.00001, respectively). Similarly, CV mortality (HR 0.86, 95% CI: 0.79–0.93, P = 0.0003, and HR 0.83, 95% CI: 0.77–0.90, P < 0.00001, respectively), and CV hospitalizations (HR 0.80 95% CI: 0.64–0.99, P = 0.04 and HR 0.76 95% CI: 0.61–0.93, P = 0.009, respectively) were reduced in these EF subgroups. Significant effects on all clinical outcomes were also found in cohort studies’ analyses; the effect was also larger and significant for lipophilic than hydrophilic statins. Conclusions In conclusion, statins may have a beneficial effect on CV outcomes irrespective of HF etiology and LVEF level. Lipophilic statins seem to be much more favorable for patients with heart failure.
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  • Pregnancy-Induced Hemophagocytic Lymphohistiocytosis: A Case Report

    Sánchez-Ato, Luis A.; Cuestas-Quiroz, Flavia A.; Agurto-Saldaña, Carla; Estela-Ayamamani, David (Springer, 2020-10-01)
    No presenta presenta resumen.
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  • Alsinol, an arylamino alcohol derivative active against Plasmodium, Babesia, Trypanosoma, and Leishmania: past and new outcomes

    Arias, Maria H.; Quiliano, Miguel; Bourgeade-Delmas, Sandra; Fabing, Isabelle; Chantal, Isabelle; Berthier, David; Minet, Cécile; Eparvier, Veronique; Sorres, Jonathan; Stien, Didier; Galiano, Silvia; Aldana, Ignacio; Valentin, Alexis; Garavito, Giovanny; Deharo, Eric (Springer Science and Business Media Deutschland GmbH, 2020-10-01)
    Malaria, babesiosis, trypanosomosis, and leishmaniasis are some of the most life-threatening parasites, but the range of drugs to treat them is limited. An effective, safe, and low-cost drug with a large activity spectrum is urgently needed. For this purpose, an aryl amino alcohol derivative called Alsinol was resynthesized, screened in silico, and tested against Plasmodium, Babesia, Trypanosoma, and Leishmania. In silico Alsinol follows the Lipinski and Ghose rules. In vitro it had schizontocidal activity against Plasmodium falciparum and was able to inhibit gametocytogenesis; it was particularly active against late gametocytes. In malaria-infected mice, it showed a dose-dependent activity similar to chloroquine. It demonstrated a similar level of activity to reference compounds against Babesia divergens, and against promastigotes, and amastigotes stages of Leishmania in vitro. It inhibited the in vitro growth of two African animal strains of Trypanosoma but was ineffective in vivo in our experimental conditions. It showed moderate toxicity in J774A1 and Vero cell models. The study demonstrated that Alsinol has a large spectrum of activity and is potentially affordable to produce. Nevertheless, challenges remain in the process of scaling up synthesis, creating a suitable clinical formulation, and determining the safety margin in preclinical models.
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  • Facial reconstruction according to aesthetic units

    Nunez Castaneda, José; Chang Grozo, Silvana (Wolters Kluwer Medknow Publications, 2020-10-01)
    Context: The facial subunit principle organizes the facial skin into subunits. Facial reconstruction for skin cancer based on aesthetic units consists of replacing the entire subunit when a large part of a subunit has been removed. Aims: To determine the prevalence of facial skin cancer, their location by facial aesthetic units, and the type of facial reconstruction used in each of them. Settings and Design: An observational cross-sectional study was conducted at the Head and Neck Surgery Service of a general hospital between 2017 and 2018. Materials and Methods: A population census was conducted during this period. Statistical Analysis Used: The categorical variables were expressed as frequencies (percentages). Continuous variables were described as the means and standard deviations or medians and interquartile ranges. Results: The most common skin cancer was basal cell skin cancer, followed by epithelial skin cancer and, at last, melanoma. In general, the most frequent localization of these cancers was the nose. Conclusions: In spite of primary closure being the most common form of reconstruction, a considerable number of patients required facial reconstruction based on aesthetic facial units, with satisfying results.
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  • Safety and efficacy of drug eluting stents vs bare metal stents in patients with atrial fibrillation: A systematic review and meta-analysis

    Sambola, Antonia; Rello, Pau; Soriano, Toni; Bhatt, Deepak L.; Pasupuleti, Vinay; Cannon, Christopher P.; Gibson, C. Michael; Dewilde, Willem J.M.; Lip, Gregory Y.H.; Peterson, Eric D.; Airaksinen, K. E.Juhani; Kiviniemi, Tuomas; Fauchier, Laurent; Räber, Lorenz; Ruiz-Nodar, Juan M.; Banach, Maciej; Bueno, Héctor; Hernandez, Adrian V. (Elsevier Ltd, 2020-11-01)
    Objective: A systematic review and meta-analysis was performed to evaluate the safety and efficacy of drug-eluting stents (DES) vs bare-metal stents (BMS) in atrial fibrillation (AF) patients. Methods: We systematically searched 5 engines until May 2019 for cohort studies and randomized controlled trials (RCTs). Primary outcomes were major bleeding and major adverse cardiac events (MACE) including cardiac death, myocardial infarction, target vessel revascularization (TVR) or stent thrombosis. Effects of inverse variance random meta-analyses were described with relative risks (RR) and their 95% confidence intervals (CI). We also stratified analyses by type (triple [TAT] vs dual [DAT]) and duration (short-vs long-term) of antithrombotic therapy. Results: Ten studies (3 RCTs; 7 cohorts) including 10,353 patients (DES: 59.6%) were identified. DES did not show higher risk of major bleeding than BMS (5.6% vs 6.9%, RR 1.07; 95%CI, 0.89–1.28, p = 0.47; I2 = 0%) or MACE (12% vs 13.6%; RR 0.96; 95%CI 0.81–1.13, p = 0.60; I2 = 44%). Although, DES almost decreased TVR risk (6.4% vs 8.4%, RR 0.78; 95%CI, 0.61–1.01, p = 0.06; I2 = 15%). Stratified analyses by type and duration of antithrombotic therapy showed no differences in major bleeding or MACE between both types of stents. In DES, long-term TAT showed higher major bleeding risk than long-term DAT (7.7% vs 4.7%, RR 1.48, 95%CI 1.08–2.03, p = 0.01; I2 = 12%). For both types of stents, MACE risk was similar between TAT and DAT. Conclusions: In patients with AF undergoing PCI, DES had similar rate of major bleeding and MACE than BMS. DAT seems to be a safer antithrombotic therapy compared with TAT.
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  • Optimizing harvesting for facial lipografting with a new photochemical stimulation concept: One STEP technique™

    Centurión, Patricio; Gamarra, Ronald; Caballero, Gonzalo; Kaufmann, Paul; Delgado, Pia (Springer Science and Business Media Deutschland GmbH, 2020-12-01)
    Background: Facial fat grafting for rejuvenation is one of the most popular facial aesthetic procedures in plastic surgery. It is always challenging and since there are a lot of techniques for adipose tissue (AT) harvesting, there are no standard procedures that guarantee natural and long-lasting results. We developed the selective tissue engineering photo stimulation technique (One STEP™) in which we used a novel infrared 1210-nm wavelength laser diode for fat preserved harvesting and direct fat injection that we named PicoGraft™, with no fat manipulation. Methods: This is a retrospective descriptive study in which we included all senior author’s patients that got facial fat grafting using the One STEP™ technique. We compared the AT aspirated, after laser emission (STEP-PicoGraft) and the standard assisted liposuction samples (SAL) in cultures. We study the mitochondrial activity of the ASC between STEP and SAL in fresh samples and after 24 h. The evaluation of the results included subjective changes regarding wrinkles, grooves, palpebral bags, hyperchromic spots, and fat hypotrophy of our patients. Results: Between July 2013 and May 2018, a total of 245 patients underwent facial fat grafting using this novel technique. We observed adipocytes preserved after STEP harvesting comparing morphologic changes in SAL samples with a high concentration of inflammatory particles in cultures. ASC mitochondrial activity shows an important difference of more than 7 times in STEP samples in fresh analysis that increase 12 times in 24 h. The subjective results show a good improvement in the periorbital area. The changes on the skin and subcutaneous tissue are seen from the second month and continue to improve up to 12 months. Conclusions: Facial fat grafting using the PicoGraft™ obtained by One STEP™ technique gives excellent volumetric and regenerative results in a single treatment without volumetric hypercorrection, and it is a good alternative for facial rejuvenation. The fat graft obtained with this novel technique is homogenous, without lumps, and has high concentration of viable stimulated ADSC and a high number of viable adipocytes. Level of evidence: Level III, therapeutic study.
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  • Phenotypic expansion in KIF1A-related dominant disorders: A description of novel variants and review of published cases

    Montenegro-Garreaud, Ximena; Hansen, Adam W.; Khayat, Michael M.; Chander, Varuna; Grochowski, Christopher M.; Jiang, Yunyun; Li, He; Mitani, Tadahiro; Kessler, Elena; Jayaseelan, Joy; Shen, Hua; Gezdirici, Alper; Pehlivan, Davut; Meng, Qingchang; Rosenfeld, Jill A.; Jhangiani, Shalini N.; Madan-Khetarpal, Suneeta; Scott, Daryl A.; Abarca-Barriga, Hugo; Trubnykova, Milana; Gingras, Marie Claude; Muzny, Donna M.; Posey, Jennifer E.; Liu, Pengfei; Lupski, James R.; Gibbs, Richard A. (John Wiley and Sons Inc, 2020-12-01)
    KIF1A is a molecular motor for membrane-bound cargo important to the development and survival of sensory neurons. KIF1A dysfunction has been associated with several Mendelian disorders with a spectrum of overlapping phenotypes, ranging from spastic paraplegia to intellectual disability. We present a novel pathogenic in-frame deletion in the KIF1A molecular motor domain inherited by two affected siblings from an unaffected mother with apparent germline mosaicism. We identified eight additional cases with heterozygous, pathogenic KIF1A variants ascertained from a local data lake. Our data provide evidence for the expansion of KIF1A-associated phenotypes to include hip subluxation and dystonia as well as phenotypes observed in only a single case: gelastic cataplexy, coxa valga, and double collecting system. We review the literature and suggest that KIF1A dysfunction is better understood as a single neuromuscular disorder with variable involvement of other organ systems than a set of discrete disorders converging at a single locus.
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  • Application of crispr/cas9-based reverse genetics in leishmania braziliensis: Conserved roles for hsp100 and hsp23

    Adaui, Vanessa; Kröber-Boncardo, Constanze; Brinker, Christine; Zirpel, Henner; Sellau, Julie; Arévalo, Jorge; Dujardin, Jean Claude; Clos, Joachim (MDPI AG, 2020-10-01)
    The protozoan parasite Leishmania (Viannia) braziliensis (L. braziliensis) is the main cause of human tegumentary leishmaniasis in the New World, a disease affecting the skin and/or mucosal tissues. Despite its importance, the study of the unique biology of L. braziliensis through reverse genetics analyses has so far lagged behind in comparison with Old World Leishmania spp. In this study, we successfully applied a cloning-free, PCR-based CRISPR–Cas9 technology in L. braziliensis that was previously developed for Old World Leishmania major and New World L. mexicana species. As proof of principle, we demonstrate the targeted replacement of a transgene (eGFP) and two L. braziliensis single-copy genes (HSP23 and HSP100). We obtained homozygous Cas9-free HSP23-and HSP100-null mutants in L. braziliensis that matched the phenotypes reported previously for the respective L. donovani null mutants. The function of HSP23 is indeed conserved throughout the Trypanosomatida as L. major HSP23 null mutants could be complemented phenotypically with transgenes from a range of trypanosomatids. In summary, the feasibility of genetic manipulation of L. braziliensis by CRISPR–Cas9-mediated gene editing sets the stage for testing the role of specific genes in that parasite’s biology, including functional studies of virulence factors in relevant animal models to reveal novel therapeutic targets to combat American tegumentary leishmaniasis.
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  • Unidentified dengue serotypes in DENV positive samples and detection of other pathogens responsible for an acute febrile illness outbreak 2016 in Cajamarca, Peru

    Del Valle-Mendoza, Juana; Vasquez-Achaya, Fernando; Aguilar-luis, Miguel Angel; Martins-Luna, Johanna; Bazán-Mayra, Jorge; Zavaleta-Gavidia, Victor; Silva-Caso, Wilmer; Carrillo-Ng, Hugo; Tarazona-Castro, Yordi; Aquino-Ortega, Ronald; Del Valle, Luis J. (BioMed Central Ltd., 2020-10-06)
    Objective: To describe the prevalence of dengue virus serotypes, as well as other viral and bacterial pathogens that cause acute febrile illness during an outbreak in Cajamarca in 2016. Results: Dengue virus (DENV) was the most frequent etiologic agent detected in 25.8% of samples (32/124), followed by Rickettsia spp. in 8.1% (10/124), Zika virus in 4.8% (6/124), Chikungunya virus 2.4% (3/124) and Bartonella bacilliformis 1.6% (2/124) cases. No positive cases were detected of Oropouche virus and Leptospira spp. DENV serotypes identification was only achieved in 23% of the total positive for DENV, two samples for DENV-2 and four samples for DENV-4. During the 2016 outbreak in Cajamarca-Peru, it was observed that in a large percentage of positive samples for DENV, the infecting serotype could not be determined by conventional detection assays. This represents a problem for the national surveillance system and for public health due to its epidemiological and clinical implications. Other viral and bacterial pathogens responsible for acute febrile syndrome were less frequently identified.
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  • Paediatric snakebite envenoming: the world's most neglected 'Neglected Tropical Disease'?

    Pach, Sophie; Le Geyt, Jacqueline; Gutiérrez, José María; Williams, David; Maduwage, Kalana Prasad; Habib, Abdulrazaq Garba; Gustin, Rafael; Avila-Agüero, María Luisa; Ya, Kyaw Thu; Halbert, Jay (NLM (Medline), 2020-12-01)
    Snakebite disproportionally affects children living in impoverished rural communities. The WHO has recently reinstated snakebites on its list of Neglected Tropical Diseases and launched a comprehensive Strategy for the Prevention and Control of Snakebite Envenoming. In the first of a two paper series, we describe the epidemiology, socioeconomic impact and key prevention strategies. We also explore current challenges and priorities including the production and distribution of safe and effective antivenom.
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  • Endemic and epidemic human alphavirus infections in eastern Panama: An analysis of population-based cross-sectional surveys

    Carrera, J. P.; Cucunuba, Zulma M.; Neira, Karen; Lambert, Ben; Pitti, Yaneth; Liscano, Jesus; Garzon, Jorge L.; Beltran, Davis; Collado-Mariscal, Luisa; Saenz, Lisseth; Sosa, Nestor; Rodriguez-Guzman, Luis D.; Gonzalez, Publio; Lezcano, Andres G.; Pereyra-Elias, Renee; Valderrama, Anayansi; Weaver, Scott C.; Vittor, Amy Y.; Armien, Blas; Pascale, Juan Miguel; Donnelly, Christl A. (American Society of Tropical Medicine and Hygiene, 2020-12-01)
    Madariaga virus (MADV) has recently been associated with severe human disease in Panama, where the closely related Venezuelan equine encephalitis virus (VEEV) also circulates. In June 2017, a fatal MADV infection was confirmed in a community of Darien Province. We conducted a cross-sectional outbreak investigation with human and mosquito collections in July 2017, where sera were tested for alphavirus antibodies and viral RNA. In addition, by applying a catalytic, force-of-infection (FOI) statistical model to two serosurveys from Darien Province in 2012 and 2017, we investigated whether endemic or epidemic alphavirus transmission occurred historically. In 2017, MADV and VEEV IgM seroprevalences were 1.6% and 4.4%, respectively; IgG antibody prevalences were MADV: 13.2%, VEEV: 16.8%, Una virus (UNAV): 16.0%, and Mayaro virus: 1.1%. Active viral circulation was not detected. Evidence of MADV and UNAV infection was found near households, raising questions about its vectors and enzootic transmission cycles. Insomnia was associated withMADVand VEEV infections, depression symptoms were associated with MADV, and dizziness with VEEV and UNAV. Force-of-infection analyses suggest endemic alphavirus transmission historically, with recent increased human exposure to MADV and VEEV in Aruza and Mercadeo, respectively. The lack of additional neurological cases suggests that severe MADV and VEEV infections occur only rarely. Our results indicate that over the past five decades, alphavirus infections have occurred at low levels in eastern Panama, but that MADV and VEEV infections have recently increased-potentially during the past decade. Endemic infections and outbreaks of MADV and VEEV appear to differ spatially in some locations of eastern Panama.
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  • The Peru approach against the COVID-19 infodemic: Insights and strategies

    Alvarez-Risco, Aldo; Mejia, Christian R.; Delgado-Zegarra, Jaime; Del-Aguila-Arcentales, Shyla; Arce-Esquivel, Arturo A.; Valladares-Garrido, Mario J.; Del Portal, Mauricio Rosas; Villegas, León F.; Curioso, Walter H.; Sekar, M. Chandra; Yáñez, Jaime A. (American Society of Tropical Medicine and Hygiene, 2020-08-01)
    The COVID-19 epidemic has spawned an "infodemic,"with excessive and unfounded information that hinders an appropriate public health response. This perspective describes a selection of COVID-19 fake news that originated in Peru and the government's response to this information. Unlike other countries, Peru was relatively successful in controlling the infodemic possibly because of the implementation of prison sentences for persons who created and shared fake news. We believe that similar actions by other countries in collaboration with social media companies may offer a solution to the infodemic problem.
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  • Carrion’s Disease: More Than a Sand Fly–Vectored Illness

    Pons, Maria J.; Gomes, Cláudia; del Valle-Mendoza, Juana; Ruiz, Joaquim (Public Library of Science, 2016-10-01)
    No presenta resumen.
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  • Older adults with disability in extreme poverty in Peru: How is their access to health care?

    Flores-Flores, Oscar; Bell, Ruth; Reynolds, Rodney; Bernabé-Ortiz, Antonio (Public Library of Science, 2018-12-01)
    Background Disability rates increase with age. In 2012, Peruvian older adults ( 65 years) represented 9% of the population. Additionally, older population reported disabilities at about 5 times the rate of Peruvians between 36 and 64 years old, and 30% of older population lived in poverty. Peruvian seniors living in extreme poverty experience disabilities and the extent of their access to healthcare is unknown. Objective This study assesses associations between disability and access to healthcare among Peruvians older individuals living in extreme poverty. Methods Secondary analysis of a national representative population based survey that utilizes information from Peru’s 2012 survey Health and Wellbeing in Older Adults (ESBAM), which includes older adults living in extreme poverty. We define disability in terms of the Activities of Daily Living (ADL disability) framework. Healthcare access was assessed as having any of Peru’s available health insurance schemes combined with preventive health services (vision assessment, influenza vaccination, blood pressure assessment, diabetes screening, and cholesterol assessment). Poisson robust regression models were used to evaluate the associations among relevant variables. Prevalence Ratios and 95% confidence intervals (95%CI) were reported. Results Data from 3869 individuals (65 to 80 years old), of whom 1760 (45.5%) were females, were analyzed. The prevalence of ADL disability was 17.3% (95%CI: 16.0%-18.4%). In addition, more than 60% had never received any of the preventive measures evaluated, except for the blood pressure assessment. In the adjusted model, people with ADL disability had 63% less probability of having extensive insurance, compared to those without disability (p<0.05). Conclusions This study shows that this Peruvian older population living in extreme poverty has limited access to healthcare services. Although there was no consistent association between ADL disability and the healthcare access, there is an urgent need to reduce the inequitable access to healthcare of this poor Peruvian older population.
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  • DNA aptamers for the recognition of HMGB1 from Plasmodium falciparum

    Joseph, Diego F.; Nakamoto, Jose A.; Garcia Ruiz, Oscar Andree; Peñaranda, Katherin; Sanchez-Castro, Ana Elena; Castillo, Pablo Soriano; Milón, Pohl (Public Library of Science, 2019-04-01)
    Rapid Diagnostic Tests (RDTs) for malaria are restricted to a few biomarkers and antibody-mediated detection. However, the expression of commonly used biomarkers varies geographically and the sensibility of immunodetection can be affected by batch-to-batch differences or limited thermal stability. In this study we aimed to overcome these limitations by identifying a potential biomarker and by developing molecular sensors based on aptamer technology. Using gene expression databases, ribosome profiling analysis, and structural modeling, we find that the High Mobility Group Box 1 protein (HMGB1) of Plasmodium falciparum is highly expressed, structurally stable, and present along all blood-stages of P. falciparum infection. To develop biosensors, we used in vitro evolution techniques to produce DNA aptamers for the recombinantly expressed HMG-box, the conserved domain of HMGB1. An evolutionary approach for evaluating the dynamics of aptamer populations suggested three predominant aptamer motifs. Representatives of the aptamer families were tested for binding parameters to the HMG-box domain using microscale thermophoresis and rapid kinetics. Dissociation constants of the aptamers varied over two orders of magnitude between nano- and micromolar ranges while the aptamer-HMG-box interaction occurred in a few seconds. The specificity of aptamer binding to the HMG-box of P. falciparum compared to its human homolog depended on pH conditions. Altogether, our study proposes HMGB1 as a candidate biomarker and a set of sensing aptamers that can be further developed into rapid diagnostic tests for P. falciparum detection.
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  • Efficacy and harms of remdesivir for the treatment of COVID-19: A systematic review and meta-analysis

    Piscoya, Alejandro; Ng-Sueng, Luis F.; del Riego, Angela Parra; Cerna-Viacava, Renato; Pasupuleti, Vinay; Roman, Yuani M.; Thota, Priyaleela; White, C. Michael; Hernandez, Adrian V. (Public Library of Science, 2020-12-01)
    Background Efficacy and safety of treatments for hospitalized COVID-19 are uncertain. We systematically reviewed efficacy and safety of remdesivir for the treatment of COVID-19. Methods Studies evaluating remdesivir in adults with hospitalized COVID-19 were searched in several engines until August 21, 2020. Primary outcomes included all-cause mortality, clinical improvement or recovery, need for invasive ventilation, and serious adverse events (SAEs). Inverse variance random effects meta-analyses were performed. Results We included four randomized controlled trials (RCTs) (n = 2296) [two vs. placebo (n = 1299) and two comparing 5-day vs. 10-day regimens (n = 997)], and two case series (n = 88). Studies used intravenous remdesivir 200mg the first day and 100mg for four or nine more days. One RCT (n = 236) was stopped early due to AEs; the other three RCTs reported outcomes between 11 and 15 days. Time to recovery was decreased by 4 days with remdesivir vs. placebo in one RCT (n = 1063), and by 0.8 days with 5-days vs. 10-days of therapy in another RCT (n = 397). Clinical improvement was better for 5-days regimen vs. standard of care in one RCT (n = 600). Remdesivir did not decrease all-cause mortality (RR 0.71, 95% CI 0.39 to 1.28, I2 = 43%) and need for invasive ventilation (RR 0.57, 95%CI 0.23 to 1.42, I2 = 60%) vs. placebo at 14 days but had fewer SAEs; 5-day decreased need for invasive ventilation and SAEs vs. 10-day in one RCT (n = 397). No differences in all-cause mortality or SAEs were seen among 5-day, 10-day and standard of care. There were some concerns of bias to high risk of bias in RCTs. Heterogeneity between studies could be due to different severities of disease, days of therapy before outcome determination, and how ordinal data was analyzed. Conclusions There is paucity of adequately powered and fully reported RCTs evaluating effects of remdesivir in hospitalized COVID-19 patients. Until stronger evidence emerges, we cannot conclude that remdesivir is efficacious for treating COVID-19.
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  • Spanish version of the Santa Clara Brief Compassion Scale: evidence of validity and factorial invariance in Peru

    Caycho-Rodríguez, Tomás; Vilca, Lindsey W.; Plante, Thomas G.; Carbajal-León, Carlos; Cabrera-Orosco, Isabel; García Cadena, Cirilo H.; Reyes-Bossio, Mario (Springer, 2020-01-01)
    The Santa Clara Brief Compassion Scale (SCBCS) is a brief measure of compassion, created in English and translated into Brazilian Portuguese. Nonetheless, to date, no study has assessed the psychometric evidence of its Spanish translation. This study examines the evidence of validity, reliability, and factorial invariance according to the gender of a Spanish version of the SCBCS. Participants included 273 Peruvian university students (50.9% women) with an average age of 21.23 years (SD = 3.24); divided into two groups of men and women to conduct the invariance factor analysis. Other measures of mindfulness, well-being, empathy, and anxiety were applied along with the SCBCS. The Confirmatory Factor Analysis (CFA) indicated that a unifactorial model adjusted significantly to the data (χ2 = 12,127, df = 5, p =.033, χ2 /df = 2.42, CFI =.998, RMSEA =.072 [CI90%.019,.125]; SRMR =.030, WRMR =.551) and presented good reliability (α =.90 [95%.88–.92]; ω =.91). Moreover, correlations between the SCBCS and other measures of mindfulness (r =.53, p <.05, cognitive empathy (r = 55; p <.05), affective empathy (r =.56, p <.05), well-being (r =.55, p <.05), and anxiety (r = −.46; p <.05) supported the convergent and discriminant validity. Likewise, the multiple-group CFA supported the factorial invariance according to the gender of the SCBCS. Results indicate that the SCBCS possesses evidence of validity, reliability, and invariance between men and women for measuring compassion toward others in Peruvian undergraduate students. SCBCS is expected to be used by researchers, healthcare professionals, teachers, and others as a useful measure of compassion in college students.
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  • Personalized Cognitive Counseling Reduces Drinking Expectancy Among Men Who Have Sex with Men and Transgender Women in Lima, Peru: A Pilot Randomized Controlled Trial

    Passaro, R. Colby; Chávez-Gomez, Susan; Castañeda-Huaripata, Angelica; Gonzales-Saavedra, Williams; Beymer, Matthew R.; Segura, Eddy R.; Nanclares, Francisco; Dilley, James; Cabello, Robinson; Clark, Jesse L. (Springer, 2020-11-01)
    Personalized cognitive counseling (PCC) is an evidence-based intervention designed to modify HIV-related risk behavior. We assessed the impact of PCC on sexual behavior, drinking expectancy, and incidence of sexually transmitted infections (STIs) in a 6-month randomized controlled trial among 153 HIV-uninfected men who have sex with men (MSM) and transgender women (TW) in Peru. Study retention was ≥ 90%, with three HIV infections (3 Control) and 19 cases of GC/CT (10 Control, 9 PCC) at 6 months. There was a decline in condomless receptive anal intercourse in the Control (0.74, 95% CI 0.60-0.91; p < 0.01) and PCC arms (0.72, 0.55-0.94; p = 0.02) at 6-month follow-up. There was a decrease in drinking expectancy at 6 months among participants endorsing alcohol use in the PCC arm (0.89, 0.83-0.96; p < 0.01), versus no change in the Control arm (0.98, 0.92-1.04; p = 0.54). PCC was efficacious in reducing drinking expectancy and HIV risk among MSM and TW in Peru.
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  • Polygenic prediction and GWAS of depression, PTSD, and suicidal ideation/self-harm in a Peruvian cohort

    Shen, Hanyang; Gelaye, Bizu; Huang, Hailiang; Rondon, Marta B.; Sanchez, Sixto; Duncan, Laramie E. (Springer Nature, 2020-09-01)
    Genome-wide approaches including polygenic risk scores (PRSs) are now widely used in medical research; however, few studies have been conducted in low- and middle-income countries (LMICs), especially in South America. This study was designed to test the transferability of psychiatric PRSs to individuals with different ancestral and cultural backgrounds and to provide genome-wide association study (GWAS) results for psychiatric outcomes in this sample. The PrOMIS cohort (N = 3308) was recruited from prenatal care clinics at the Instituto Nacional Materno Perinatal (INMP) in Lima, Peru. Three major psychiatric outcomes (depression, PTSD, and suicidal ideation and/or self-harm) were scored by interviewers using valid Spanish questionnaires. Illumina Multi-Ethnic Global chip was used for genotyping. Standard procedures for PRSs and GWAS were used along with extra steps to rule out confounding due to ancestry. Depression PRSs significantly predicted depression, PTSD, and suicidal ideation/self-harm and explained up to 0.6% of phenotypic variation (minimum p = 3.9 × 10−6). The associations were robust to sensitivity analyses using more homogeneous subgroups of participants and alternative choices of principal components. Successful polygenic prediction of three psychiatric phenotypes in this Peruvian cohort suggests that genetic influences on depression, PTSD, and suicidal ideation/self-harm are at least partially shared across global populations. These PRS and GWAS results from this large Peruvian cohort advance genetic research (and the potential for improved treatments) for diverse global populations.
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