Empleo del modelo animal en la formación en endoscopia diagnóstica y terapéutica de la vía biliar

Objetivo. Mostrar nuestra experiencia en la formación en endoscopia terapéutica de la vía biliar en modelo animal. Materiales y métodos. Esta actividad formativa tiene una duración de 13 horas y comienza iniciando al alumno en las diferencias anatómicas de las especies que se emplean, la porcina y la canina, con respecto a la anatomía humana. Las prácticas consisten en habituar al endoscopista a la visión lateral del duodenoscopio; se realizan en un modelo porcino debido a que es más sencillo atravesar el esfínter pilórico, aunque no suele ser muy adecuado para la canulación de la papila duodenal. Tras superar la primera fase se utiliza el modelo canino, que permite adquirir las habilidades y destrezas propias de esta técnica. La evaluación de los resultados se realiza mediante una encuesta anónima. Resultados. El 76% de los alumnos confirma que ha avanzado mucho con este entrenamiento, un 18% regular y un 6% poco. El 75% considera que, tras realizar esta actividad de formación, se encontraría capacitado para llevar a cabo la técnica en su hospital. El 94% de los alumnos recomendaría esta actividad a sus compañeros. Conclusiones. El empleo del modelo animal en la formación en colangiopancreatografía retrógada endoscópica (CPRE) permite la adquisición de habilidades básicas necesarias para la práctica, ya que posibilita la repetición de las maniobras y la tutela continuada. Consideramos que con esta metodología mixta se podría acortar la curva de aprendizaje de la CPRE y disminuiría la iatrogenia en las primeras fases

Particle film technology modulates xanthophyll cycle and photochemical dynamics of grapevines grown in the Douro Valley

Field-grown grapevines are often exposed to multiple environmental stresses, which challenges wine-growers to develop sustainable measures to sustain vine growth, yield, and quality. Under field conditions this task is demanding, due to differences in the magnitudes of stresses and associated plant responses. In this study we explored the hypothesis that kaolin-particle film application improves grapevine photoprotection through the regulation of xanthophyll cycle genes, limiting the thermal dissipation of excess energy under harsh environmental conditions. Hence, we selected two grapevine varieties, Touriga-Nacional (TN) and Touriga-Franca (TF), grown in the Douro Demarcated Region, and evaluated changes in light dissipation mechanisms, xanthophyll cycle components, and the expression of xanthophyll cycle genes during the 2017 summer season. The results showed that, from veraison to ripening, kaolin triggered the up-regulation of violaxanthin de-epoxidase (VvVDE1) and zeaxanthin epoxidase (VvZEP1) genes, indicating optimised regulation of the xanthophyll cycle. Kaolin treatment also decreased chlorophyll (Chla, Chlb, Chl(a+b)) and carotenoid (Car) accumulation under increasing summer stress conditions in both varieties and lowered the non-photochemical quenching (NPQ) of grapevines on ripening, suggesting a long-term response to summer stress. In addition, kaolin-treated grapevines showed increased Chla/Chlb and lower Chl(a+b)/Car ratios, displaying some features of high light adapted leaves. Overall, this study suggests that kaolin application enabled grapevines to benefit from fluctuating periods of summer stress by managing chlorophyll and carotenoid content and limiting down-regulation of both photochemistry and photoinhibition processes. Under Mediterranean field conditions, kaolin application can be considered an efficient method of minimising summer stress impact on grapevines.This work was supported by National Funds by FCT - Portuguese Foundation for Science and Technology, under the project UIDB/04033/2020, the Clim4Vitis project – “Climate change impact mitigation for European viticulture: knowledge transfer for an integrated approach”, funded by the European Union's Horizon 2020 Research and Innovation programme, under grant agreement no. 810176, and by the project I&D&I AgriFood XXI, operation NORTE-01-0145-FEDER-000041, co-funded by the European Regional Development Fund (FEDER) through NORTE 2020 (Programa Operacional Regional do Norte, 2014/2020). Sara Bernardo acknowledges the financial support provided by the FCT-Portuguese Foundation for Science and Technology (PD/BD/128273/2017) under the Doctoral Programme “Agricultural Production Chains – from Fork to Farm”.Peer reviewe

Use of Blood Donor Screening Data to Estimate Zika Virus Incidence, Puerto Rico, April–August 2016

Puerto Rico has been heavily impacted by Zika virus, a mosquitoborne flavivirus that emerged in the Americas during 2015. Although most persons with Zika virus show no symptoms, the virus can cause neurologic and other complications, including fetal microcephaly. Local Zika virus transmission in Puerto Rico has been reported since December 2015. To prevent transfusion-associated transmission, local blood collection ceased in March 2016 but resumed in April 2016 after Zika virus screening of blood donations became available. Using data from screening of blood donations collected by the 2 largest blood centers in Puerto Rico during April 3–August 12, 2016, and assuming a 9.9-day duration of viremia, we estimated that 469,321 persons in Puerto Rico were infected during this period, for an estimated cumulative incidence of 12.9%. Results from blood donation screening during arboviral outbreaks can supplement routine clinical and surveillance data for improved targeting of prevention efforts

Prognostic implications of vitamin D deficiency in chronic kidney disease

Chronic kidney disease (CKD) is a highly prevalent disease, imposing high mortality rates worldwide, and it is closely related to cardiovascular events. Vitamin D deficiency is very prevalent in patients with CKD from the earliest stages of the disease, and it has been associated with higher mortality. In order to assess the prognostic implications of vitamin D deficiency in CKD, we undertook a literature review, searching different databases in October 2018 for publications related to vitamin D in patients with CKD and hypovitaminosis D, and not on dialysis. The main cause of death in these patients is cardiovascular disease. Vitamin D is one of the first parameters that CKD changes and has an important prognostic role in this entity. Deficient levels in blood are associated with increased cardiovascular risk and survival impacts, independently of cardiovascular disease. Treatment with paricalcitol appears to reduce this risk. However, the evidence analyzed is insufficient to establish an association between vitamin D levels and the progression of kidney disease.&nbsp