Comparación: injerto libre o cierre primario más lente de contacto, en resección de tumores de conjuntiva limbar

INTRODUCCION: Existe controversia en cuanto a la técnica quirúrgica para el manejo de tumores del limbo conjuntival. El uso de cierre primario con uso de lente de contacto puede ofrecer una mejor cicatrización y tener ventajas adicionales sobre la técnica tradicional con el uso de plastia. OBJETIVOS: Comparar los resultados en cuanto a grado de dolor, picadas, prurito, porcentaje de epitelización y cicatrización, comodidad del paciente, grado de quemosis y tiempo de retorno a actividades diarias en ambas técnicas quirúrgicas. MATERIALES Y METODOS: Experimento clínico controlado aleatorizado en dos grupos: Al primer grupo se le realizó cirugía de resección de la lesión más plastia. Al segundo grupo se le practicó la resección de la lesión cierre primario y lente de contacto. El seguimiento se realizó al primer y cuarto día, y cada semana durante el primer mes de postoperatorio. Se utilizó el SPSS 20.0 ® para análisis estadístico de datos y se utilizó estadística no paramétrica. RESULTADOS: Se conto con 10 pacientes por grupo. El dolor y porcentaje de cicatrización al primer día postoperatorio fueron mayores en el grupo usando lente de contacto (p=0.048). Al cuarto día postquirúrgico se encontró un mayor porcentaje de cicatrización en el grupo usando lente de contacto. (p=0.075). CONCLUSIONES: El cierre por afrontamiento con uso de lente de contacto mostró dolor y picadas mayores al primer y cuarto día postoperatorio. Pero la epitelización y cicatrización fueron tempranas con un retorno corto a actividades cotidianas.

Presión arterial en preescolares de la localidad de Usaquén en Bogotá

Introducción: La hipertensión arterial es un problema de salud pública tanto en países industrializados como en vía de desarrollo. Su prevalencia en la infancia viene en aumento por lo que es relevante determinarla en niños preescolares a nivel local. Objetivo: Determinar la prevalencia de hipertensión arterial en niños de tres a cinco años de una cohorte de 14 hogares infantiles del ICBF de la localidad de Usaquén en Bogotá. Materiales y métodos: Se realizó un estudio de corte transversal analítico, utilizando la base de datos de un ensayo aleatorizado y controlado del año 200913, y se evaluaron las cifras de tensión arterial de acuerdo a sexo, edad, talla y su correlación con el IMC con un nivel de confianza del 95% y precisión del 1%. Se calcularon las medias, desviaciones estándar, percentiles y prevalencia. Resultados: Se obtuvo una muestra de 1035 casos, encontrándose una prevalencia de 4,5% de HTA sistólica, 10,4% de diastólica, ambas en estadio I; teniendo en cuenta tanto sistólica como diastólica, fue de 11,6% en estadio I. Se determinaron los valores de presión arterial sistólica y diastólica en cuartiles de acuerdo a edad, sexo y talla. El coeficiente de correlación entre el IMC y los niveles de presión arterial sistólica y diastólica fueron de 0.0992 y 0.0362 respectivamente. Conclusión: La prevalencia de HTA general fue de 11,6%, predominando la diastólica en estadio I en niños preescolares. No se encontró correlación entre el IMC y las cifras de tensión arterial sistólica y diastólica.

Sensibilidad del cuestionario anamnésico de síntomas de miembro superior y columna desarrollado por la unidad de investigación de ergonómica de postura y movimiento (EPM) desde la perspectiva de la fisioterapia en Colombia

El propósito de este estudio es evaluar la sensibilidad, especificidad y valores predictivos del Cuestionario Anamnésico de Síntomas de Miembro Superior y Columna (CASMSC) desarrollado por la Unidad de Investigación de Ergonomía de Postura y Movimiento (EPM). Se realizó un estudio descriptivo de tipo correlacional, mediante el análisis de datos secundarios de una base de datos con registros de trabajadores de la industria de alimentos (n=401) en el año 2013, a quienes se les había aplicado el CASMSC, así como una evaluación clínica fisioterapéutica enfocada en los mismos segmentos corporales; esta última utilizada como prueba de oro. Para analizar si existían diferencias estadísticas por edad, antigüedad y género se aplicó el análisis de varianza de una vía. La sensibilidad, especificidad y valores predictivos del CASMSC se informan con sus respectivos intervalos de confianza (95%). La prevalencia de umbral positivo para sospecha de Desorden Músculo Esquelético (DME) tanto de miembro superior como de columna se encontró muy por encima de la media nacional para el sector. La sensibilidad del CASMSC para miembro superior estuvo en el rango de un 80% a 94,57% y para columna cervical y lumbar fue de 36,4% y 43,4%, respectivamente. Para la región dorsal fue casi del doble de las otras dos regiones (85,7%). El CASMSC es recomendable en su apartado para miembro superior dado a su alto nivel de sensibilidad.

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Molecular modelling studies of binding of DACD derivatives into G-Quadruplex DNA: comparison of force field and quantum polarized ligand docking methods

The DNA G-qadruplexes are one of the targets being actively explored for anti-cancer therapy by inhibiting them through small molecules. This computational study was conducted to predict the binding strengths and orientations of a set of novel dimethyl-amino-ethyl-acridine (DACA) analogues that are designed and synthesized in our laboratory, but did not diffract in Synchrotron light.Thecrystal structure of DNA G-Quadruplex(TGGGGT)4(PDB: 1O0K) was used as target for their binding properties in our studies.We used both the force field (FF) and QM/MM derived atomic charge schemes simultaneously for comparing the predictions of drug binding modes and their energetics. This study evaluates the comparative performance of fixed point charge based Glide XP docking and the quantum polarized ligand docking schemes. These results will provide insights on the effects of including or ignoring the drug-receptor interfacial polarization events in molecular docking simulations, which in turn, will aid the rational selection of computational methods at different levels of theory in future drug design programs. Plenty of molecular modelling tools and methods currently exist for modelling drug-receptor or protein-protein, or DNA-protein interactionssat different levels of complexities.Yet, the capasity of such tools to describevarious physico-chemical propertiesmore accuratelyis the next step ahead in currentresearch.Especially, the usage of most accurate methods in quantum mechanics(QM) is severely restricted by theirtedious nature. Though the usage of massively parallel super computing environments resulted in a tremendous improvement in molecular mechanics (MM) calculations like molecular dynamics,they are still capable of dealing with only a couple of tens to hundreds of atoms for QM methods. One such efficient strategy that utilizes thepowers of both MM and QM are the QM/MM hybrid methods. Lately, attempts have been directed towards the goal of deploying several different QM methods for betterment of force field based simulations, but with practical restrictions in place. One of such methods utilizes the inclusion of charge polarization events at the drug-receptor interface, that is not explicitly present in the MM FF.

Decadal climate prediction: an update from the trenches

This paper provides an update on research in the relatively new and fast-moving field of decadal climate prediction, and addresses the use of decadal climate predictions not only for potential users of such information but also for improving our understanding of processes in the climate system. External forcing influences the predictions throughout, but their contributions to predictive skill become dominant after most of the improved skill from initialization with observations vanishes after about six to nine years. Recent multi-model results suggest that there is relatively more decadal predictive skill in the North Atlantic, western Pacific, and Indian Oceans than in other regions of the world oceans. Aspects of decadal variability of SSTs, like the mid-1970s shift in the Pacific, the mid-1990s shift in the northern North Atlantic and western Pacific, and the early-2000s hiatus, are better represented in initialized hindcasts compared to uninitialized simulations. There is evidence of higher skill in initialized multi-model ensemble decadal hindcasts than in single model results, with multi-model initialized predictions for near term climate showing somewhat less global warming than uninitialized simulations. Some decadal hindcasts have shown statistically reliable predictions of surface temperature over various land and ocean regions for lead times of up to 6-9 years, but this needs to be investigated in a wider set of models. As in the early days of El Niño-Southern Oscillation (ENSO) prediction, improvements to models will reduce the need for bias adjustment, and increase the reliability, and thus usefulness, of decadal climate predictions in the future.

Characteristics of tropical cyclones in high-resolution models in the present climate

The global characteristics of tropical cyclones (TCs) simulated by several climate models are analyzed and compared with observations. The global climate models were forced by the same sea surface temperature (SST) fields in two types of experiments, using climatological SST and interannually varying SST. TC tracks and intensities are derived from each model's output fields by the group who ran that model, using their own preferred tracking scheme; the study considers the combination of model and tracking scheme as a single modeling system, and compares the properties derived from the different systems. Overall, the observed geographic distribution of global TC frequency was reasonably well reproduced. As expected, with the exception of one model, intensities of the simulated TC were lower than in observations, to a degree that varies considerably across models.

Hurricanes and climate: the U.S. CLIVAR working group on hurricanes

While a quantitative climate theory of tropical cyclone formation remains elusive, considerable progress has been made recently in our ability to simulate tropical cyclone climatologies and understand the relationship between climate and tropical cyclone formation. Climate models are now able to simulate a realistic rate of global tropical cyclone formation, although simulation of the Atlantic tropical cyclone climatology remains challenging unless horizontal resolutions finer than 50 km are employed. This article summarizes published research from the idealized experiments of the Hurricane Working Group of U.S. CLIVAR (CLImate VARiability and predictability of the ocean-atmosphere system). This work, combined with results from other model simulations, has strengthened relationships between tropical cyclone formation rates and climate variables such as mid-tropospheric vertical velocity, with decreased climatological vertical velocities leading to decreased tropical cyclone formation. Systematic differences are shown between experiments in which only sea surface temperature is increased versus experiments where only atmospheric carbon dioxide is increased, with the carbon dioxide experiments more likely to demonstrate the decrease in tropical cyclone numbers previously shown to be a common response of climate models in a warmer climate. Experiments where the two effects are combined also show decreases in numbers, but these tend to be less for models that demonstrate a strong tropical cyclone response to increased sea surface temperatures. Further experiments are proposed that may improve our understanding of the relationship between climate and tropical cyclone formation, including experiments with two-way interaction between the ocean and the atmosphere and variations in atmospheric aerosols.

An assessment of air-sea heat fluxes from ocean and coupled reanalyses

Sixteen monthly air–sea heat flux products from global ocean/coupled reanalyses are compared over 1993–2009 as part of the Ocean Reanalysis Intercomparison Project (ORA-IP). Objectives include assessing the global heat closure, the consistency of temporal variability, comparison with other flux products, and documenting errors against in situ flux measurements at a number of OceanSITES moorings. The ensemble of 16 ORA-IP flux estimates has a global positive bias over 1993–2009 of 4.2 ± 1.1 W m−2. Residual heat gain (i.e., surface flux + assimilation increments) is reduced to a small positive imbalance (typically, +1–2 W m−2). This compensation between surface fluxes and assimilation increments is concentrated in the upper 100 m. Implied steady meridional heat transports also improve by including assimilation sources, except near the equator. The ensemble spread in surface heat fluxes is dominated by turbulent fluxes (>40 W m−2 over the western boundary currents). The mean seasonal cycle is highly consistent, with variability between products mostly <10 W m−2. The interannual variability has consistent signal-to-noise ratio (~2) throughout the equatorial Pacific, reflecting ENSO variability. Comparisons at tropical buoy sites (10°S–15°N) over 2007–2009 showed too little ocean heat gain (i.e., flux into the ocean) in ORA-IP (up to 1/3 smaller than buoy measurements) primarily due to latent heat flux errors in ORA-IP. Comparisons with the Stratus buoy (20°S, 85°W) over a longer period, 2001–2009, also show the ORA-IP ensemble has 16 W m−2 smaller net heat gain, nearly all of which is due to too much latent cooling caused by differences in surface winds imposed in ORA-IP.

Dysregulation of granulosal bone morphogenetic protein receptor 1B density is associated with reduced ovarian reserve and the age-related decline in human fertility

Reproductive ageing is linked to the depletion of ovarian primordial follicles, which causes an irreversible change to ovarian cellular function and the capacity to reproduce. The current study aimed to profile the expression of bone morphogenetic protein receptor, (BMPR1B) in 53 IVF patients exhibiting different degrees of primordial follicle depletion. The granulosa cell receptor density was measured in 403 follicles via flow cytometry. A decline in BMPR1B density occurred at the time of dominant follicle selection and during the terminal stage of folliculogenesis in the 23-30 y good ovarian reserve patients. The 40+ y poor ovarian reserve patients experienced a reversal of this pattern. The results demonstrate an association between age-induced depletion of the ovarian reserve and BMPR1B receptor density at the two critical time points of dominant follicle selection and pre-ovulatory follicle maturation. Dysregulation of BMP receptor signalling may inhibit the normal steroidogenic differentiation required for maturation in older patients.

The Climate-system Historical Forecast Project: do stratosphere-resolving models make better seasonal climate predictions in boreal winter?

Using an international, multi-model suite of historical forecasts from the World Climate Research Programme (WCRP) Climate-system Historical Forecast Project (CHFP), we compare the seasonal prediction skill in boreal wintertime between models that resolve the stratosphere and its dynamics (“high-top”) and models that do not (“low-top”). We evaluate hindcasts that are initialized in November, and examine the model biases in the stratosphere and how they relate to boreal wintertime (Dec-Mar) seasonal forecast skill. We are unable to detect more skill in the high-top ensemble-mean than the low-top ensemble-mean in forecasting the wintertime North Atlantic Oscillation, but model performance varies widely. Increasing the ensemble size clearly increases the skill for a given model. We then examine two major processes involving stratosphere-troposphere interactions (the El Niño-Southern Oscillation/ENSO and the Quasi-biennial Oscillation/QBO) and how they relate to predictive skill on intra-seasonal to seasonal timescales, particularly over the North Atlantic and Eurasia regions. High-top models tend to have a more realistic stratospheric response to El Niño and the QBO compared to low-top models. Enhanced conditional wintertime skill over high-latitudes and the North Atlantic region during winters with El Niño conditions suggests a possible role for a stratospheric pathway.

Discovering biomarkers for antidepressant response: protocol from the Canadian biomarker integration network in depression (CAN-BIND) and clinical characteristics of the first patient cohort

Background Major Depressive Disorder (MDD) is among the most prevalent and disabling medical conditions worldwide. Identification of clinical and biological markers (“biomarkers”) of treatment response could personalize clinical decisions and lead to better outcomes. This paper describes the aims, design, and methods of a discovery study of biomarkers in antidepressant treatment response, conducted by the Canadian Biomarker Integration Network in Depression (CAN-BIND). The CAN-BIND research program investigates and identifies biomarkers that help to predict outcomes in patients with MDD treated with antidepressant medication. The primary objective of this initial study (known as CAN-BIND-1) is to identify individual and integrated neuroimaging, electrophysiological, molecular, and clinical predictors of response to sequential antidepressant monotherapy and adjunctive therapy in MDD. Methods CAN-BIND-1 is a multisite initiative involving 6 academic health centres working collaboratively with other universities and research centres. In the 16-week protocol, patients with MDD are treated with a first-line antidepressant (escitalopram 10–20 mg/d) that, if clinically warranted after eight weeks, is augmented with an evidence-based, add-on medication (aripiprazole 2–10 mg/d). Comprehensive datasets are obtained using clinical rating scales; behavioural, dimensional, and functioning/quality of life measures; neurocognitive testing; genomic, genetic, and proteomic profiling from blood samples; combined structural and functional magnetic resonance imaging; and electroencephalography. De-identified data from all sites are aggregated within a secure neuroinformatics platform for data integration, management, storage, and analyses. Statistical analyses will include multivariate and machine-learning techniques to identify predictors, moderators, and mediators of treatment response. Discussion From June 2013 to February 2015, a cohort of 134 participants (85 outpatients with MDD and 49 healthy participants) has been evaluated at baseline. The clinical characteristics of this cohort are similar to other studies of MDD. Recruitment at all sites is ongoing to a target sample of 290 participants. CAN-BIND will identify biomarkers of treatment response in MDD through extensive clinical, molecular, and imaging assessments, in order to improve treatment practice and clinical outcomes. It will also create an innovative, robust platform and database for future research.