Clinical and anatomopathological features of eosinophilic oesophagitis in children and adults

Introduction: Eosinophilic oesophagitis (EoE) is a chronic clinical-pathological disorder with an immunological basis characterised by symptoms of oesophageal dysfunction and, histologically, eosinophilic inflammation. Objective: To evaluate the clinical characteristics and differences in children and adults diagnosed with EoE in a tertiary level hospital. Method: Descriptive, retrospective and cross-sectional study. We randomly selected 40 children and 40 adults diagnosed with EoE between 2009 and 2016. The patient characteristics were analysed by means of epidemiological, clinical, diagnostic and therapeutic variables. Results: The average age at diagnosis was 10 years (children) and 34 years (adults), with a higher frequency in males. The majority were sensitised to aeroallergens (77.5% children vs. 82.5% adults) and foods (75% children vs. 82.5% adults). Statistically significant differences were detected in sensitisation to fruits (p = 0.007) and grains (p < 0.001). Differences were observed in impaction (22.5% children vs. 82.5% adults), dysphagia (42.5% children vs. 77.5% adults) and abdominal pain (25% children vs. 7.5% adults). Endoscopy showed that children had a higher frequency of exudates (92.5%) and adults, trachealisation (50% vs. 5%) and stenosis (17.5% vs. 2.5%). Statistically significant differences were found in treatment with topical corticosteroids (30% children vs. 77.5% adults), with a variable positive response. 77.5% of the patients received elimination diets. Conclusions: Statistically significant differences were observed between the paediatric and adult populations in the food sensitisation profiles, clinical manifestations, endoscopic findings and treatments received. This is a complex pathology that calls for a multidisciplinary team and would require new non-invasive techniques to facilitate its management

Specific effect of arachidonic acid on 17β-hydroxysteroid dehydrogenase in rat Leydig cells

AbstractIt is well known that arachidonic acid (AA) acts as an intratesticular factor regulating luteinizing hormone-mediated testicular steroidogenesis. The present studies were conducted to determine the effect of AA on steroidogenic enzymes in rat Leydig cells. Exogenously added AA significantly inhibited 22(R)-hydroxy-cholesterol-stimulated testosterone production, which is a clear indication that AA is acting at some point after cholesterol transport to the inner mitochondrial membrane. AA failed to block the conversion of 22(R)-hydroxycholesterol to pregnenolone, indicating that the cytochrome P-450 side-chain cleavage enzyme complex is not the site of inhibition. The present results demonstrate that only 17β-hydroxysteroid dehydrogenase seems to be involved in the AA action, since nearly 60% inhibition of testosterone production was found when the cells were incubated with androstenedione. Furthermore, no effect of AA was found when androstenediol was used as substrate in the testosterone synthesis, which indicates that 3β-hydroxysteroid dehydrogenase is not affected by AA. The conversion of AA to its metabolites is not required for its action on 17β-hydroxysteroid dehydrogenase and the activation of protein kinase C is not involved in the inhibitory effect

Proyecto incliasma - inercia clínica en asma

Objetivos: El asma es una enfermedad de alta prevalencia que limita la calidad de vida de los pacientes y tiene elevados costes sanitarios. A pesar de disponer de guías de práctica clínica, se sigue detectando un deficiente control del asma. El objetivo de este proyecto es estudiar el manejo del asma desde las consultas de atención primaria de Aragón, España. Material y métodos: Estudio cualitativo, multicéntrico y no aleatorizado, que se desarrolló en dos rondas, siguiendo la metodología Delphi. Se pidió a un grupo de médicos de Atención Primaria con amplia experiencia en el manejo del asma que expresaran su nivel de acuerdo con el conjunto de ítems del cuestionario propuesto por el comité científico del proyecto. El cuestionario de 28 ítems se estructuró en cuatro bloques: diagnóstico, control, adherencia y tratamiento. Resultados: El cuestionario fue respondido por 15 panelistas. Hubo consenso en el 82,14% (23/28) de los ítems. Se encontraron dificultades para diagnosticar el asma de forma precoz y certera. Existe una confusión entre control y gravedad. La percepción de adherencia es muy variable. Hay un sobreuso de broncodilatadores de acción corta. Se evidencia mucha inercia terapéutica. Conclusiones: El estudio Inercia Clínica en Asma (INCLIASMA) pone de relieve las controversias encontradas entre lo que aconsejan las guías de práctica clínica y la evidencia real y ofrece recomendaciones para subsanar las diferencias encontradas

Sal k 5, a member of the widespread Ole e 1-like protein family, is a new allergen of Russian thistle (Salsola kali) pollen.

Salsola kali is an Amaranthaceae weed with important repercussions for pollinosis in temperate areas. Ole e 1-like members are relevant allergens in pollen from different species. We aimed to characterize and produce as recombinant allergen S. kali Ole e 1-like protein. METHODS:The natural allergen was purified at homogeneity after three chromatographic steps. Specific cDNA was sequenced and expressed in Pichia pastoris yeast. Structural relationships of natural and recombinant forms were carried out by 2D electrophoresis and spectroscopic analyses. Its immunological relevance was analyzed by ELISA and immunoblotting using an IgG antiserum and monoclonal antibodies specific to Ole e 1, as well as sera from 57 allergic patients recruited from two Spanish regions where this pollinosis is frequent. RESULTS:The purified allergen, Sal k 5, is an acidic glycoprotein of 151 amino acid residues and 17,628 Da of molecular mass. Its amino acid sequence exhibits 68 and 32% identity with the allergens of Che a 1 and Ole e 1, respectively. The recombinant protein was correctly processed and its structural and immunologic equivalence to the natural form was proven. A sensitization frequency between 30 and 40% was observed in pollinic patients from the center and east coast of Spain. CONCLUSIONS:Sal k 5 is a member of the Ole e 1-like protein family which can be considered an important allergen from S. kali. Its inclusion in diagnosis protocols would allow the accurate defining of patients allergic to this pollen

The Role of Epigenetics in the Progression of Clear Cell Renal Cell Carcinoma and the Basis for Future Epigenetic Treatments

Clear cell renal cell carcinoma (ccRCC) is curable when diagnosed at an early stage, but when disease is non-confined it is the urologic cancer with worst prognosis. Antiangiogenic treatment and immune checkpoint inhibition therapy constitute a very promising combined therapy for advanced and metastatic disease. Many exploratory studies have identified epigenetic markers based on DNA methylation, histone modification, and ncRNA expression that epigenetically regulate gene expression in ccRCC. Additionally, epigenetic modifiers genes have been proposed as promising biomarkers for ccRCC. We review and discuss the current understanding of how epigenetic changes determine the main molecular pathways of ccRCC initiation and progression, and also its clinical implications. Despite the extensive research performed, candidate epigenetic biomarkers are not used in clinical practice for several reasons. However, the accumulated body of evidence of developing epigenetically-based biomarkers will likely allow the identification of ccRCC at a higher risk of progression. That will facilitate the establishment of firmer therapeutic decisions in a changing landscape and also monitor active surveillance in the aging population. What is more, a better knowledge of the activities of chromatin modifiers may serve to develop new therapeutic opportunities. Interesting clinical trials on epigenetic treatments for ccRCC associated with well established antiangiogenic treatments and immune checkpoint inhibitors are revisited.Instituto de Salud Carlos IIIComisión Europe

Checklist for the Multidisciplinary Approach to United Airway in Patients with Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) and asthma

Dear Editor, The united airways concept calls for a multidisciplinary approach to asthma and/or chronic rhinitis/rhinosinusitis (CRS), aimed at integral airway treatment1, 2 and better coordination among specialists.3 Failure to treat rhinitis/rhinosinusitis is associated with poor asthma control, especially of severe asthma.4, 5 Biological treatments targeting type 2 (T2) inflammatory mediators in severe respiratory diseases offer a new therapeutic option directed against the pathophysiological mechanism of these difficult-to-control united airways diseases (UAD)..

A micromachined thermoelectric sensor for natural gas analysis: Multivariate calibration results

The potential use of a micromachined thermopile based sensor device for analyzing natural gas is explored. The sensor consists of a thermally isolated hotplate, which is heated by the application of a sequence of programmed voltages to an integrated heater. Once the hotplate reaches a stationary temperature, the thermopile provides a signal proportional to the hotplate temperature. These signals are processed in order to determine different natural gas properties. Sensor response is mainly dependent on the thermal conductivity of the surrounding gas at different temperatures. Seven predicted properties (normal density, superior heating value, Wobbe index and the concentrations of methane, ethane, carbon dioxide and nitrogen) are calibrated against sensor signals by using multivariate regression, in particular partial least squares. Experimental data have been used for calibration and validation. Results show property prediction capability with reasonable accuracy except for prediction of carbon dioxide concentration. A detailed uncertainty analysis is provided to better understand the metrological limits of the system. These results imply for the first time the possibility of designing unprecedented low-cost natural gas analyzers. The concept may be extended to other constrained gas mixtures (e.g. of a known number of components) to enable low-cost multicomponent gas analyzers

Reproducción del pargo gris (Teleostei: Lutjanidae) en el sur del Golfo de México

Snappers exhibit reproductive trait plasticity in response to habitat distribution. Lutjanus griseus is among the most economically important snappers in the western Central Atlantic but has received limited study in the region. Data on the reproductive biology of the L. griseus population were collected on the continental shelf of the Yucatan Peninsula, Mexico. Over a nineteen-month period, 1236 specimens were captured monthly in three Yucatan artisanal fishing fleet operational areas. Data were grouped by month to generate an annual analysis. Individual sex and maturation status were identified by gonad histology. Median size did not differ between females (33.2 cm fork length [FL]) and males (33.3 cm FL), and the sex ratio was balanced (F:M=0.98:1.00). Size at maturity was 24.2 cm FL for females (38% of maximum size reported for the species) and 22.8 cm FL for males (36% of maximum size), and the spawning season ran from May to September. The results confirm that this population exhibits the typical reproductive pattern of snappers distributed on continental shelves or in shallow water areas and provide critical data for stock assessment and implementation of management measures for L. griseus stock in the southern Gulf of Mexico.Los pargos exhiben plasticidad en sus rasgos reproductivos según su hábitat de distribución. Lutjanus griseus es uno de los pargos de mayor interés económico en el Atlántico Central Occidental, pero ha sido poco estudiado en esta región. Este trabajo analiza la biología reproductiva de la población de L. griseus de la plataforma continental de la Península de Yucatán, México. En un periodo de un año y medio natural se capturaron 1236 especímenes en tres áreas operativas de la flota pesquera artesanal de Yucatán. Los datos fueron agrupados por meses para generar un análisis anual. El sexo y el estado de maduración de cada individuo fueron determinados mediante el análisis histológico de sus gónadas. No se observó una diferencia significativa entre las medianas de las tallas de las hembras (33.2 cm LF) y de los machos (33.3 cm LF), y la proporción sexual fue equilibrada (H:M=0.98:1.00). Los datos obtenidos sobre las tallas de madurez fueron de 24.2 cm LF para las hembras (38% de la talla máxima de la especie) y de 22.8 cm LF (36% de la talla máxima) para los machos y la temporada de desove ocurrió entre mayo y septiembre. Estas características confirmaron que la población presenta el patrón de reproducción típico de los pargos distribuidos en plataformas continentales o en zonas de agua somera. Estos resultados proporcionan datos críticos para la evaluación y la aplicación de medidas de gestión de la población de L. griseus del sur del Golfo de México

Rethinking globalised resistance : feminist activism and critical theorising in international relations

This article argues that a feminist approach to the 'politics of resistance' offers a number of important empirical insights which, in turn, open up lines of theoretical inquiry which critical theorists in IR would do well to explore. Concretely, we draw on our ongoing research into feminist 'anti-globalisation' activism to rethink the nature of the subject of the politics of resistance, the conditions under which resistance emerges and how resistance is enacted and expressed. We begin by discussing the relationship of feminism to critical IR theory as a way of situating and explaining the focus and approach of our research project. We then summarise our key empirical arguments regarding the emergence, structure, beliefs, identities and practices of feminist 'anti-globalisation' activism before exploring the implications of these for a renewed critical theoretical agenda in IR