Chronic Elevation of Liver Enzymes in Acute Intermittent Porphyria Initially Misdiagnosed as Autoimmune Hepatitis

Autoimmune hepatitis is a disease characterized by an elevation of liver enzymes, as well as specific autoantibodies. It is more common in women than men. We describe a 32-year-old woman with elevated transaminases, autoantibodies, and a liver biopsy result suggestive of autoimmune hepatitis. The indicated treatment was administered without showing a satisfactory response. The patient had a family history of acute intermittent porphyria (AIP) so we decided to begin treatment with hematin, achieving a complete remission of the symptoms. Acute intermittent porphyria is a rare condition characterized by neurovisceral symptoms, abdominal pain being the most common of them. The disease has a higher prevalence among young women and certain European countries such as Sweden, Great Britain, and Spain. A correct diagnosis and prompt treatment are essential because patients affected by AIP must have a strict followup due to the fatal outcome of the outbreaks

Role of the Renin-Angiotensin System and Aldosterone on Cardiometabolic Syndrome

Aldosterone facilitates cardiovascular damage by increasing blood pressure and through different mechanisms that are independent of its effects on blood pressure. In this respect, recent evidence involves aldosterone in the pathogenesis of metabolic syndrome. Although this relationship is complex, there is some evidence suggesting that different factors may play an important role, such as insulin resistance, renin-angiotensin-aldosterone system, oxidative stress, sodium retention, increased sympathetic activity, levels of free fatty acids, or inflammatory cytokines and adipokines. In addition to the classical pathway by which aldosterone acts through the mineralocorticoid receptors leading to sodium retention, aldosterone also has other mechanisms that influence cardiovascular tissue remodelling. Finally, overweight and obesity promote the adrenal secretion of aldosterone, increasing the predisposition to type 2 diabetes mellitus. Further studies are needed to better establish therapeutic strategies that act on the blockade of mineralocorticoid receptor in the treatment and prevention of cardiovascular diseases related to the excess of aldosterone and the metabolic syndrome

Using the new technologies in claudication patients: CReTe: Claudication patients and telematic register

Objetivo: Presentamos una aplicación informática para teléfonos móviles ideada para el control de sesiones de ejercicio domiciliario en claudicantes. Exponemos también nuestros resultados preliminares. Material y métodos: La aplicación está dise˜nada para teléfonos móviles con sistema operativo Android, tecnología de geolocalización y conexión de datos. Está conectada a una base de datos codificada que preserva el secreto médico. Los datos que se recogen de las sesiones de ejercicio son la fecha, la hora de inicio y de fin, el tiempo dedicado, el número de las paradas realizadas y la velocidad máxima, la velocidad media global y la velocidad entre paradas. Durante el mes de enero de 2014 se reclutó a aquellos pacientes que aceptaran el estudio, poseyeran y entendieran un dispositivo móvil Android con geolocalización y conexión de datos. Los criterios de exclusión del estudio una vez comenzado fueron progresión hacia isquemia arterial crítica, enfermedad intercurrente grave, fallecimiento y ausencia de comunicación con el paciente. Se recogieron las principales morbilidades y los resultados de los cuestionarios de calidad de vida SF36 y EuroQol 5D. Se midió el tiempo de primera consulta y el tiempo dedicado por semana y paciente durante un seguimiento de 28 días. Se calculó el cumplimiento de las sesiones con respecto a las sesiones pactadas con cada paciente, con un mínimo de 2 semanales. Resultados: Un total de 5 pacientes fueron incluidos, con edad media de 59,3 a˜nos (mediana 52; rango 40-80). De ellos 2 se excluyeron, uno por progresión a isquemia crítica y otro por ausencia de comunicación. El tiempo medio dedicado por consulta nueva fue de 29,1 min (mediana 27,5; rango 45-20). El cumplimiento de las sesiones fue del 100% en 2 pacientes y del 63% en otro. El tiempo dedicado en el seguimiento semanal por paciente fue de 1,68 min. Conclusiones: CReTe es una herramienta aplicable a nuestro medio que precisa de estudios mayores para demostrar su utilidad.Objective: The preliminary results are presented on the use of a new application for mobile phones designed to control home exercise sessions in claudication.Materials and methods: The application is designed for Android systems with geolocation tech-nology and Internet connection. It is connected to a database encoded to ensure medical confidentiality. The data collected from the exercise sessions were the date, start time and end time, the time spent, the number of stops made, and the maximum speed, average speed and overall speed between stops. During the month of January 2014 patients who accepted and understood the study, and possessed an Android mobile device with geolocation and data connection, were enrolled. The exclusion criteria, 11 the study started, were progression to arterial ischemia, severe intercurrent illness, non-communication with the patient, and death. Major morbidities and results of quality of life questionnaires SF36 and EuroQol 5 D were collec-ted. Time of first consultation and time spent per week per patient during a 28-day follow-up was recorded. Compliance as regards the agreed sessions was calculated for each patient, with a minimum of 2 weeks.Results: The study included 5 patients with a mean age 59.3 years (median 52; range 40-80). Of these, 2 were excluded, one for progression to critical ischemia and another for non-communication. The average time spent in a new consultation was 29.1 minutes (median 27.5, range 45-20). The compliance with the sessions was 100% in 2 patients, and 63% in another. Time spent in the weekly monitoring per patient was 1.68 minutes.Conclusions: CReTe is an applicable tool in our environment that requires further study to demonstrate its usefulness

Changes in soil organic matter composition after Scots pine afforestation in a native European beech forest revealed by analytical pyrolysis (Py-GC/MS)

The introduction of coniferous species in former deciduous forests may exert changes in soil organic matter, particularly in its molecular composition. In this work, pyrolysis-gas chromatography-mass spectrometry was used to study changes in SOM quality related to the centennial afforestation of Scots pine in an area formerly covered by European beech forest in the NE-flank of the Moncayo Natural Park (NE-Spain). For each soil profile three organic layers (fresh litter, fragmented litter and humified litter) and mineral soil horizons (Ah, E, Bhs and C) were studied. A total of 128 compounds were identified in the pyrograms, and composition differences were detected among the organic and mineral soil layers as well as between soils under beech and pine, for the main compound classes: nitrogen compounds, aromatics, lignin methoxyphenols, polycyclic aromatic hydrocarbons, lipids and polysaccharide-derived moieties. Such chemical differences were found to be derived from the biomass composition of the predominant vegetation type that was incorporated into the soil and from its progression into the soil profile. The analysis of the distribution of alkanes indicated higher SOM stabilization in the native beech forest soil. The signal of beech biomarkers (long chain n-alkanes C31-C33) found in the pine E horizon indicates the permanence of SOM derived from the natural forest ca. 100 years after the afforestation.publishe

Superparamagnetic iron oxide nanoparticle-loaded polyacrylonitrile nanofibers with enhanced arsenate removal performance

Novel nanocomposite sorbents of superparamagnetic iron oxide nanoparticles (SPION) supported onto electrospun polyacrylonitrile nanofibers were synthesized by a simple and scalable method. The influence of both nanofiber size and SPION loading on As(V) adsorption capacity was studied and optimization was conducted. A maximum uptake capacity of 32.5 mmol As(V) per gram SPION in batch mode tests using an extremely low loading of only 2.9 mg of SPION per gram of adsorbent was achieved. This represents a remarkable improvement of 36 times compared with SPION in suspension. The optimal material was tested in continuous flow operation mode, reaching an adsorption capacity of 851.7 mg As(V) per gram of adsorbent at pH 3.8. It is also demonstrated that the new adsorbents can retain high performance when tested under real conditions using polluted wastewater from a lixiviation dump containing a large amount of competing anions (Cl- and F- ) and interfering cations (K+, Na+, Mg2+, and Ca2+). Furthermore, there was no release of nanoparticles observed during the operation and the spent porous material can be compressed, generating a small amount of solid waste that can be easily treated or stored

A systematic review of the adherence to home-practice meditation exercises in patients with chronic pain

Mindfulness-, compassion-, and acceptance-based (i.e., “third wave”) psychotherapies are effective for treating chronic pain conditions. Many of these programs require that patients engage in the systematic home practice of meditation experiences so they can develop meditation skills. This systematic review aimed at evaluating the frequency, duration, and effects of home practice in patients with chronic pain undergoing a “third wave” psychotherapy. A comprehensive database search for quantitative studies was conducted in PubMed, Embase, and Web of Sciences Core Collection; 31 studies fulfilled the inclusion criteria. The reviewed studies tended to indicate a pattern of moderately frequent practice (around four days/week), with very high variability in terms of time invested; most studies observed significant associations between the amount of practice and positive health outcomes. Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy were the most common interventions and presented low levels of adherence to home practice (39.6% of the recommended time). Some studies were conducted on samples of adolescents, who practiced very few minutes, and a few tested eHealth interventions with heterogeneous adherence levels. In conclusion, some adaptations may be required so that patients with chronic pain can engage more easily and, thus, effectively in home meditation practices

Drug Repurposing for Cancers With Limited Survival: Protocol for a Retrospective Cohort Study

Only 5% of the molecules tested in oncology phase 1 trials reach the market after an average of 7.5 years of waiting and at a cost of tens of millions of dollars. To reduce the cost and shorten the time of discovery of new treatments, drug repurposing (research with molecules already approved for another indication) and the use of secondary data (not collected for the purpose of research) have been proposed. Due to advances in informatics in clinical care, secondary data can, in some cases, be of equal quality to primary data generated through prospective studies.Objective: The objective of this study is to identify drugs currently marketed for other indications that may have an effect on the prognosis of patients with cancer.Methods: We plan to monitor a cohort of patients with high-lethality cancers treated in the public health system of Catalonia between 2006 and 2012, retrospectively, for survival for 5 years after diagnosis or until death. A control cohort, comprising people without cancer, will also be retrospectively monitored for 5 years. The following study variables will be extracted from different population databases: type of cancer (patients with cancer cohort), date and cause of death, pharmacological treatment, sex, age, and place of residence. During the first stage of statistical analysis of the patients with cancer cohort, the drugs consumed by the long-term survivors (alive at 5 years) will be compared with those consumed by nonsurvivors. In the second stage, the survival associated with the consumption of each relevant drug will be analyzed. For the analyses, groups will be matched for potentially confounding variables, and multivariate analyses will be performed to adjust for residual confounding variables if necessary. The control cohort will be used to verify whether the associations found are exclusive to patients with cancer or whether they also occur in patients without cancer.Results: We anticipate discovering multiple significant associations between commonly used drugs and the survival outcomes of patients with cancer. We expect to publish the initial results in the first half of 2024.Conclusions: This retrospective study may identify several commonly used drugs as candidates for repurposing in the treatment of various cancers. All analyses are considered exploratory; therefore, the results will have to be confirmed in subsequent clinical trials. However, the results of this study may accelerate drug discovery in oncology

Estudio fenológico y caracterización morfológica de variedades tradicionales de manzano y melocotonero

Las variedades locales de frutales seleccionadas a lo largo de los años por los agricultores, son muy interesantes para preservar la biodiversidad y los recursos fitogenéticos, ya que presentan unas características organolépticas peculiares y un valor cultural irremplazable. En 2007 se inició un trabajo de recuperación de variedades tradicionales de frutales en Andalucía (Proyecto INIA, RF2007-00027- C06-05) que contempla su prospección, localización, recogida de material vegetal, caracterización morfológica y molecular, multiplicación, documentación y mantenimiento en colección. En este trabajo se han caracterizado morfológicamente mediante caracteres UPOV las flores, hojas y ramos de un año, de cinco variedades tradicionales de manzano (Malus x domestica Borkh.) y dos de melocotonero [Prunus persica (L) Batsch], no estudiadas con anterioridad. Se ha evaluado la floración en la campaña 2011 y se han realizado los fenogramas correspondientesMICINN, INIA y Fondos FEDE