Background: Obstructive Sleep Apnea (OSA) is often undiagnosed in heart failure (HF) patients. Early identification using affordable sleep studies could improve patient outcomes in resource-limited clinical settings like Peru. The objective was to determine the frequency of OSA in hospitalized HF patients using respiratory polygraphy (RP) (Sleep Study Type III). Materials and methods: A cross-sectional study was conducted. We included patients >18 years, hospitalized with exacerbated HF, and a STOP-BANG score ≥ 3. Enrolled patients underwent overnight RP using ApneaLink Air™. Data collected included clinical parameters, the Epworth Sleepiness Scale, and echocardiography results. Statistical analysis was carried out using R Studio. Results: Of 46 enrolled patients, 39 underwent successful RP; 84.61% were diagnosed with OSA. Patients exhibited a mean Apnea-Hypopnea Index (AHI) of 14.41 ± 10.08/h with mild (51.28%), moderate (25.64%), and severe (7.69%) cases. Symptoms associated with OSA included a lack of restorative sleep and concentration problems. RP data showed a mean minimum SpO2% of 76.85 ± 9.99% and an Oxygen Desaturation Index (ODI) of 20.01 ± 10.66. Correlation analysis indicated a strong positive correlation between AHI and ODI (r = 0.73, p < 0.001) and a moderate negative correlation between AHI and LVEF (r =-0.64, p = 0.056). Conclusion: This study reveals a high frequency of previously undiagnosed OSA among hospitalized heart failure patients in our institution, indicating the importance of active screening in this high-risk population.

Objective: To evaluate the clinicopathological characteristics of patients, surgery-related factors, and microbial patterns in patients diagnosed with chronic granulomatous mastitis (GM) treated at a public hospital in Lima, Peru. Methods: Retrospective study that included 161 women diagnosed with chronic GM at the Hospital de Emergencias Grau, Seguro Social de Salud, Lima, Peru, between 2019 and 2021. The diagnosis of GM was established based on anatomical and microbiological criteria. We evaluated clinicopathological features, and factors associated with the need for oncoplastic surgery and postsurgical complications. Additionally, we analyzed 26 out of 161 breast tissue samples to detect the presence of pathogens using next-generation sequencing (NGS). Results: The average age was 37.7 ± 8.4 years, 53.9% reported the use of hormonal contraceptives, and 14.8% displayed elevated prolactin. Eighty percent of patients received corticosteroids, and 50.9% underwent surgical intervention, with 22.5% experiencing postsurgical complications. Factors associated with the need for surgery included the presence of a tumor, inflammation, shorter disease duration, higher Breast Imaging-Reporting and Data System classification, lesion size of 2–5 cm, and corticosteroid use. A recurrence rate of 3.8% was identified. Among the 26 analyzed samples, Corynebacterium was detected in 80.8%, with Corynebacterium kroppenstedtii identified in 13 of the 26 (50%) samples. Conclusion: Medical treatment was the initial choice for all patients, nearly half underwent oncoplastic surgery, with some postsurgical complications reported. Nonetheless, chronic GM recurrence was low. Corynebacterium was the most frequently identified genus through NGS.

No presenta resumen

Background: Disorders of gut–brain interaction (DGBI) are multifactorial. Early-life events are proposed as factors involved in their etiopathogenesis. The relationship between mode of delivery, prematurity, and DGBI development remains unclear. This study examines whether cesarean delivery and prematurity contribute to early childhood DGBI. Methods: Caregivers of children aged 1 month to 4 years from four Colombian cities participated in a cross-sectional study. Pediatricians completed the Spanish-validated Questionnaire of Pediatric Gastrointestinal Symptoms Rome IV (QPGS-IV). Data of children born by cesarean delivery and prematurity were compared with controls. Categorical data were analyzed using Fisher’s exact test, and odds ratios (ORs) with 95% confidence intervals (CIs). Results: DGBIs were identified in 26.6% of children, with functional constipation (FC) being the most prevalent (22.3%). Among children born via cesarean section (54.3%), 30.4% of them had a DGBI (OR = 1.54, 95% CI = 1.20–1.96, p = 0.00), and 26.3% had FC (OR = 1.67, 95% CI = 1.29–2.18, p = 0.00). Prematurity was observed in 12.6% of children and was associated with a higher prevalence of DGBI (35.7%, (OR = 1.64, 95% CI = 1.16–2.29, p = 0.00), with FC affecting 30.8% (OR = 1.66, 95% CI = 1.16–2.35, p = 0.00). Conclusions: Cesarean delivery and prematurity were found to be associated with DGBI in early childhood, particularly FC. These findings highlight the need for further research to explore potential mechanisms and confirm these associations.

Introduction Anterior cruciate ligament reconstruction (ACLR) is one of the most common surgical procedures in sports orthopedics; however, there is a lack of literature related to this topic in Peru. This study aimed to describe the current surgical preferences in ACLR among Peruvian orthopedic surgeons. Methods An analytical cross-sectional study based on an online survey sent to 500 Peruvian orthopedic surgeons, supplemented with physical surveys distributed during the “IX OrthoTrauma Update” congress held in October 2022 in Lima, Peru. The survey collected demographic characteristics (e.g., residence area, health care sector), employment characteristics (e.g., experience as orthopedic surgeon, experience in ACLR), and surgical preferences for ACLR (choice of femoral tunnel drilling technique, choice of graft, tourniquet use). A total of 162 surgeons responded (32.4%). Results A total of 134 responses were analyzed. 50% (n = 67; 95% CI: 41.5–58.5) of orthopedic surgeons had more than 10 years of experience, and 53.7% (n = 72; 95% CI: 45.2–62.1) had less than 5 years of experience in ACLR. Anteromedial portal was the most popular choice for femoral tunnel drilling (62.7%; n = 84; 95% CI: 54.1–70.5). Additionally, 85.1% preferred using autograft and 83.6% (n = 114; 95% CI: 77.9–90.2) of surgeons reported a preference to obtain the graft from hamstrings. Conclusions To our knowledge, this is the first report to describe the surgical preferences for ACLR among Peruvian orthopedic surgeons, revealing a predominant preference for autografts and hamstring tendon grafts, as well as a high frequency of the anteromedial (AM) portal technique and variability in tourniquet use.

Sin resumen

Background/Objectives: Solanezumab is a humanized monoclonal antibody designed to bind soluble amyloid-beta (Aβ) and facilitate its clearance from the brain, aiming to slow the progression of Alzheimer’s disease (AD). Methods: A systematic search was applied in four medical databases through October 2024 to identify phase 2 or 3 randomized controlled trials evaluating solanezumab in patients aged ≥50 years with mild AD or in preclinical stages. The primary outcomes were changes in cognitive and functional scales, including ADAS-cog14, MMSE, ADCS-ADL, and CDR-SB. Data were pooled using a random-effects model, and certainty of evidence was assessed using GRADE. Results: Seven trials involving 4181 participants were included. Solanezumab did not significantly reduce cognitive decline based on ADAS-cog14 (MD = −0.75; 95% CI: −2.65 to 1.15; very low certainty) or improve functional scores on ADCS-ADL (MD = 0.85; 95% CI: −1.86 to 3.56; very low certainty) and CDR-SB (MD = −0.15; 95% CI: −0.89 to 0.60; very low certainty). A modest but statistically significant improvement was observed in MMSE scores (MD = 0.59; 95% CI: 0.33 to 0.86; moderate certainty). Conclusions: While solanezumab may offer slight benefits in general cognitive performance, its overall impact on clinically meaningful outcomes remains limited. The results do not support its use as a disease-modifying therapy for Alzheimer’s disease in either preclinical or symptomatic stages.

Background: Out-of-hospital cardiac arrest (OHCA) is a major public health problem. This study aims to describe the international variations in the practices related to the initiation, termination, and refraining from resuscitation of adult patients (≥18 years) with a non-traumatic OHCA. Methods: An exploratory descriptive study was conducted using a cross-sectional online survey. The respondents were recruited using snowball sampling technique. Framework analysis was used to identify key themes in responses, with descriptive statistics summarising data trends. Results: The study collected responses from 59 countries. Our findings reveal that respondents from 59.3% of countries reported that they initiate resuscitation in all cases where the patients do not show obvious signs of irreversible death or do not have confirmed advance directives. Respondents from 15.3% of countries reported that once started, prehospital resuscitation attempts are not terminated. Prehospitally respondents from 20.3% of the countries reported that they rely exclusively on specific criteria to decide when to terminate resuscitation efforts while in 45.8%, these decisions are made at the discretion of the provider. Respondents from most countries (91.5%) reported that they refrain from resuscitation in the presence of obvious signs of irreversible death. Respondents from 57.6% of countries, reported that they refrained from resuscitation if the patient had a confirmed do-not-attempt-cardiopulmonaryresuscitation (DNACPR), while 15.3% mentioned staff safety as a reason to abstain from attempting resuscitation. Conclusion: This study reveals global variation in EMS resuscitation practices, reflecting disparities in resources, healthcare infrastructure, EMS system design, community acceptability given cultural and societal norms, and legislation.

Background: Preadolescence is a critical developmental stage marked by the start of significant physical and cognitive changes posing youths at risk for psychopathology. This study explores the association of Instagram usage with body dissatisfaction, drive for thinness and psychopathological symptoms among preadolescents. Methods: We recruited 232 female preadolescents aged 9–10 years and their mothers using a snowball sampling technique. Participants were divided into two groups based on their Instagram addiction levels: no addiction (Group 1) and addiction (Group 2). Measures included the Eating Disorders Inventory-Referral Form (EDI-3-RF), Instagram Addiction Scale (IAS-15), and Child Behavior Checklist (CBCL). Results: Results showed that Group 2 had significantly higher scores in body dissatisfaction, drive for thinness, emotional reactivity, and withdrawal compared to Group 1. Conclusions: Limitations include the small, homogenous sample, reliance on self-report measures, and cross-sectional design, which limits causal inference. Future research should include more diverse samples, longitudinal designs, and a broader assessment of social media use to better understand these complex relationships. Addressing these limitations will enhance our understanding and contribute to developing effective interventions to support the mental health of preadolescents in the digital age. Level III: Evidence obtained from well-designed cohort or case–control analytic studies.

Ribosome assembly is a multistep process that ensures a functional ribosome structure. The molecular mechanism that ribosome­associated GTPases (RA­GTPases) use to enhance ribosome assembly accuracy remains largely to be elucidated. Here, we use systematic evolution of ligands by exponential enrichment (SELEX), followed by sequencing, comprehensive bioinformatics analysis, and biochemical characterization to identify aptamers that target the RA-GTPase ERA of Staphylococcus aureus. ELONA and thermophoresis assays show that the AptERA 2 interaction with ERA is in the 200 nM range of affinity, displays a high level of specificity, and depends on the target structure. Docking to ERA suggests that AptERA 2 interacts with the protein’s KH domain, consistent with the aptamer’s similarities with helix 45 of the 16S rRNA. AptERA 2 did interact with the isolated KH domain but did not bind to the ∆KH ERA nor to the similar RA-GTPase RbgA, which shares the GTPase core but lacks the KH domain, confirming that the aptamer recognizes and binds the KH domain of ERA. This interaction leads to a significant reduction of 30S-dependent GTP hydrolysis, indicative of allosteric modulation of the enzyme activity or limiting ERA binding or the KH domain interaction with the 3’ end of the 16S rRNA rather than directly blocking GTP binding. Altogether, this work highlights the versatility of aptamers as tools to understand the complex processes of ribosome biogenesis further, offering new insights into bacterial protein synthesis mechanisms.