Notes

β-lactam prescription medication: A summary from a medical chemistry point of view.
Simulation programs are useful for the acquisition of procedural skills which are retained over time.
Simulation programs are useful for the acquisition of procedural skills which are retained over time.
The assessment of frailty among older people could help to reduce its social and health burden.

To determine and characterize the prevalence of frailty in Chilean older adults.

We studied 233 participants, aged > 60 years, participating in the Chilean National Health Survey 2016-2017. Frailty was assessed using modified Fried criteria. Thus, people classified as frail should meet at least 3 out of the 5 criteria (low strength, low physical activity, low body mass index, slow walking pace and tiredness).

The prevalence of frailty was 10.9% (7.7% for men and 14.1% for women). The prevalence of pre-frailty was 59.0% whereas 30.1% of participants were classified as robust. At the age of 80 years 58 and 62% of men and women were frail, respectively. These figures increased to 90 and 87% at the age of 90 years. The prevalence of pre-frailty increased from 43 to 92.1% among men and from 76% and 78% among women from the ages of 60 to 90 years, respectively.

The prevalence of frailty increased markedly with age. It is important to implement prevention strategies to allow an early identification of high-risk individuals.
The prevalence of frailty increased markedly with age. It is important to implement prevention strategies to allow an early identification of high-risk individuals.
Patients hospitalized with suspected ST-segment elevation myocardial infarction (STEMI) who have normal coronary arteries (CAs) on invasive coronary angiography (ICA) may have an AMI or another acute cardiac disease that mimics it.

To evaluate the usefulness of cardiac magnetic resonance imaging (CMRI) for diagnosing conditions resembling AMI with normal CAs.

We studied 424 consecutive patients admitted with suspected STEMI who underwent ICA. Those with normal CAs underwent CMRI involving cine-CMRI sequences to evaluate segmental wall motion, T2-weighted short-tau inversion-recovery imaging to detect oedema and delayed contrast enhancement (DCE) after gadolinium administration to identify necrosis/fibrosis. Patients with previous myocardial infarction were excluded.

Twenty-six patients (6.1%) had normal CAs. Definitive diagnosis after CMRI was acute myocarditis in 11 patients (42.3%) whose DCE was localized in the subepicardium or intramyocardially but not in the endocardium, AMI in nine patients (34.6%) who had subendocardial or transmural DCE, and Takotsubo cardiomyopathy (TCM) in six patients (23.1%), whose CMRI showed regional contractility abnormalities of the left ventricle and myocardial oedema but not DCE.

Cardiac magnetic resonance imaging allows a precise diagnosis of acute myocardial infarction in patients with angiographically normal coronary arteries.
Cardiac magnetic resonance imaging allows a precise diagnosis of acute myocardial infarction in patients with angiographically normal coronary arteries.
The prevalence of cholelithiasis and gallbladder cancer may be different across ethnic groups.

To study the prevalence of cholelithiasis and gallbladder cancer among Aymara individuals.

An abdominal ultrasound was carried out in a sample of 182 Aymara women aged 46 ± 16 years and 76 Aymara men aged 55 ± 16 years. In addition, the histopathological reports of both patients with a history of previous cholecystectomy and those operated after the study were reviewed.

Ultrasound was normal in 150 participants (58%), 76 had cholelithiasis (30%) and 32 (12%) had a history of cholecystectomy. Pathological reports of the excised gallbladder were available for 106 cases and showed a chronic cholecystitis in 98% of cases. Gallbladder cancer was not reported.

There is a 42% prevalence of cholelithiasis and no gallbladder cancer in this sample of Aymara population.
There is a 42% prevalence of cholelithiasis and no gallbladder cancer in this sample of Aymara population.
In December 2019, coronavirus disease 2019 (COVID-19) emerged in Wuhan city and spread rapidly throughout China and the world.

To describe the clinical features, risk factors, and predictors of hospitalization in adult patients treated for acute respiratory infections associated with coronavirus SARS-CoV-2.

Descriptive prospective study of ambulatory and hospitalized adult patients with confirmed COVID-19 attended between April 1 and May 31, 2020. Clinical features, chronic comorbidities and demographic data were recorded, and patients were followed for two months as outpatients.

We assessed 1,022 adults aged 41 ± 14 years (50% men) with laboratory-confirmed COVID-19. One-third had comorbidities, specially hypertension (12.5%), hypothyroidism (6.6%), asthma (5.4%) and diabetes (4.5%). Hospital admission was required in 11%, 5.2% were admitted to critical care unit and 0.9% were connected to mechanical ventilation. Common symptoms included fatigue (55.4%), fever (52.5%), headache (68.6%), anosmia/dysgeusia (53.2%), dry cough (53.4%), dyspnea (27.4%) and diarrhea (35.5%). One third of patients reported persistence of symptoms at one-month follow-up, specially fatigue, cough and dyspnea. In the multivariate analysis, age, fever, cough, dyspnea and immunosuppression were associated with hospitalization and ICU admission. Age, male sex and moderate-severe dyspnea were associated with requirement of mechanical ventilation. The main predictors of prolonged clinical course were female sex, presence of comorbidities, history of dyspnea, cough, myalgia and abdominal pain.

Clinical features of COVID-19 were highly unspecific. Prediction models for severity, will help medical decision making at the primary care setting.
Clinical features of COVID-19 were highly unspecific. Prediction models for severity, will help medical decision making at the primary care setting.
This prospective observational study aimed to clarify the incidence and independent risk factors of wound infection after laparoscopic surgery for primary colonic and rectal cancer.

A prospective surveillance of surgical site infection (SSI) was conducted in consecutive patients with primary colorectal cancer, who underwent elective laparoscopic surgery in a single comprehensive cancer center between 2005 and 2014. The outcomes of interest were the incidence and risk factors of wound infection.

In total, 3170 patients were enrolled in the study. The overall incidence of wound infection was 3.0%. The incidence of wound infection was significantly higher in rectal surgery than in colonic surgery (4.7 vs. 2.1%,
 < 0.001). In rectal surgery, independent risk factors for developing wound infection included abdominoperineal resection (
 < 0.001, odds ratio [OR] = 11.4, 95% confidence interval [CI] 5.04-24.8), body mass index (BMI) ≥ 25kg/m
(
 = 0.041, OR = 1.97, 95% CI, 1.03-3.76), and chemoradiotherapy (
 = 0.032, OR = 2.18, 95% CI, 1.07-4.45). In laparoscopic colonic surgery, no significant risk factors were identified.

Laparoscopic rectal surgery has a higher risk of wound infection than colonic surgery. Laparoscopic rectal surgery involving abdominoperineal resection, patients with higher BMI, and chemoradiotherapy requires careful observation in wound care and countermeasures against wound infection.
Laparoscopic rectal surgery has a higher risk of wound infection than colonic surgery. Laparoscopic rectal surgery involving abdominoperineal resection, patients with higher BMI, and chemoradiotherapy requires careful observation in wound care and countermeasures against wound infection.Anal Squamous Cell Carcinoma (ASCC) is a rare cancer that has a rapidly increasing incidence in areas with highly developed economies. ASCC is strongly associated with HIV and there appears to be increasing numbers of younger male persons living with HIV (PLWH) diagnosed with ASCC. This is a retrospective cohort study of HIV positive and HIV negative patients diagnosed with primary ASCC between January 2000 and January 2020 in a demographic group with high prevalence rates of HIV. One Hundred and seventy six patients were included, and clinical data was retrieved from multiple, prospective databases. A clinical subgroup was identified in this cohort of younger HIV positive males who were more likely to have had a prior diagnosis of Anal Intraepithelial Neoplasia (AIN). Gender and HIV status had no effect on staging or disease-free survival. PLWH were more likely to develop a recurrence (p  less then  0.000) but had a longer time to recurrence than HIV negative patients, however this was not statistically significant (46.1 months vs. 17.5 months; p = 0.077). Patients known to have a previous diagnosis of AIN were more likely to have earlier staging and local tumour excision. Five-year Disease-Free Survival was associated with tumour size and the absence of nodal or metastatic disease (p  less then  0.000).[This corrects the article DOI 10.1371/journal.ppat.1009209.].[This corrects the article DOI 10.1371/journal.pone.0239636.].The massive growth of potentially toxic cyanobacteria in water supply reservoirs, such as Legedadi Reservoir (Ethiopia), poses a huge burden to water purification units and represents a serious threat to public health. In this study, we evaluated the efficiency of the flocculants/coagulants chitosan, Moringa oleifera seed (MOS), and poly-aluminium chloride (PAC) in settling cyanobacterial species present in the Legedadi Reservoir. We also tested whether coagulant-treated reservoir water promotes cyanobacteria growth. Our data showed that suspended solids in the turbid reservoir acted as ballast, thereby enhancing settling and hence the removal of cyanobacterial species coagulated with chitosan, Moringa oleifera seed, or their combination. Compared to other coagulants, MOS of 30 mg/L concentration, with the removal efficiency of 93.6%, was the most effective in removing cyanobacterial species without causing cell lysis. Contrary to our expectation, PAC was the least effective coagulant. Moreover, reservoir water treated with MOS alone or MOS combined with chitosan did not support any growth of cyanobacteria during the first two weeks of the experiment. Our data indicate that the efficacy of a flocculant/coagulant in the removal of cyanobacteria is influenced by the uniqueness of individual lakes/reservoirs, implying that mitigation methods should consider the unique characteristic of the lake/reservoir.[This corrects the article DOI 10.1371/journal.ppat.1009232.].[This corrects the article DOI 10.1371/journal.pone.0230615.].
Even after curative resection, pancreatic ductal adenocarcinoma (PDAC) patients suffer a high rate of recurrence. There is an unmet need to predict which patients will experience early recurrence after resection in order to adjust treatment strategies.

Data of patients with resectable PDAC undergoing surgical resection between January 2005 and September 2018 were reviewed to stratify for early recurrence defined as occurring within 6 months of resection. Preoperative data including demographics, tumor markers, blood immune-inflammatory factors and clinicopathological data were examined. We employed Elastic Net, a sparse modeling method, to construct models predicting early recurrence using these multiple preoperative factors. As a result, seven preoperative factors were selected age, duke pancreatic monoclonal antigen type 2 value, neutrophillymphocyte ratio, systemic immune-inflammation index, tumor size, lymph node metastasis and is peripancreatic invasion. Repeated 10-fold cross-validations were performed, and area under the receiver operating characteristic curve (AUC) and decision curve analysis were used to evaluate the usefulness of the models.
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