A System “PUMP”ed to Its Limits: A Case of Proton Pump Inhibitor-Induced Acute Interstitial Nephritis

Proton pump inhibitors (PPIs) are some of the most commonly prescribed medications. Patients are given PPIs in the hospital as GI prophylaxis or sometimes as long-term therapies to reduce the symptoms of gastroesophageal reflux disease and gastrointestinal ulcers1. There has been increasing data, including case reports implicating PPIs with acute interstitial nephritis and acute renal failure3. A 26-year-old female with no past medical history presented to the emergency department (ED) complaining of the inability to voiding urine, facial swelling, and non-radiating, bilateral flank pain for three days. The patient was seen in the ED 10-days prior due to gastritis and was subsequently discharged with pantoprazole. Initial labs revealed eosinophilia, creatinine:15.20 and BUN:57. Labs acquired 10-days prior showed a creatinine:1.05 and BUN:8. Urinalysis showed 200mg/dL(proteins), 13(WBCs/hpf) and 14(RBCs/hpf). Renal ultrasound revealed increased echotexture consistent with medical renal disease and without obstructions. Catheterization liberated minimal urine thus prompting emergent hemodialysis. Urine microscopy revealed WBCs casts. She underwent four hemodialysis sessions showing significant clinical improvement and was discharged on day 12 with a Cr:2.4 and producing \u3e2L/day of urine. Although, the effectiveness of PPI treatment is undisputable, there is a growing body of evidence documenting their association with adverse effects4. This clinical vignette showcases the rare but potential, rapid onset acute interstitial nephritis associated with the use of PPIs. Therefore, prompt recognition of this adverse effect is imperative to improve patients’ outcomes. We recommend exercising caution when prescribing PPIs by performing close monitoring of renal function and stay vigilant for other side effects

Ecuación de la vida

— Es igual a la lluvia, producto de un día nublado, frío y mal calcado. Un dibujo mal hecho, un guión mal escrito, un retrato mal pintado. — ¿De qué hablas? — La vida. — La vida no es un retrato. — Es lo que quiero que sea. — Es lo que quieres ver de la vida. Ciego a lo que quieres no significa que sea lo que quieres que sea. — Bien. Pues observa. Haré de ella lo que pueda para que sea lo que quiera. — ¿Y si fallas

Labor docente y clima organizacional en la Escuela de Intendencia del Ejército - 2018

El objetivo de la presente investigación fue determinar de qué manera se relaciona la labor docente con el clima organizacional en la Escuela de Intendencia del Ejército – 2018. El enfoque de la investigación fue cuantitativo, de tipo aplicada, nivel descriptivo, de diseño no experimental. La población estuvo compuesta por 18 docentes, y la muestra fue de tipo censal. Se les aplicó una encuesta de 14 preguntas con una escala de cinco categorías de respuestas referida a ambas variables. Este instrumento tuvo una alta confiabilidad de 0.910. Se realizó el análisis correspondiente a los resultados de la encuesta llegando a la demostración empírica de que un 84.4% apoya o considera positivamente los requerimientos de los indicadores y las dimensiones propuestas en el instrumento; esto fue ampliamente corroborado y contrastado empleando el chi cuadrado. Se concluyó que la labor docente se relaciona directamente con el clima organizacional en la Escuela de Intendencia del Ejército – 2018.The objective of the present investigation was to determine how the teaching work is related to the organizational climate in the School of Intendance of the Army - 2018. The research focus was quantitative, applied type, descriptive level, non-experimental design. The population was composed of 18 teachers, and the sample was census type. A questionnaire of 14 questions was applied with a scale of five categories of answers referring to both variables. This instrument had a high reliability of 0.910. The analysis corresponding to the results of the survey was made, arriving at the empirical demonstration that 84.4% positively supports or considers the requirements of the indicators and the dimensions proposed in the instrument; this was widely corroborated and contrasted using the chi square. It was concluded that the teaching work is directly related to the organizational climate in the School of Intendance of the Army - 2018

Chaos signatures in the short and long time behavior of the Out-of-Time ordered correlator

Two properties are needed for a classical system to be chaotic: exponential stretching and mixing. Recently, out-of-time order correlators were proposed as a measure of chaos in a wide range of physical systems. While most of the attention has previously been devoted to the short time stretching aspect of chaos, characterized by the Lyapunov exponent, we show for quantum maps that the out-of-time correlator approaches its stationary value exponentially with a rate determined by the Ruelle-Pollicot resonances. This property constitutes clear evidence of the dual role of the underlying classical chaos dictating the behavior of the correlator at different timescales.Fil: Garcia-Mata, Ignacio. Universidad Nacional de Mar del Plata; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones Marinas y Costeras. Universidad Nacional de Mar del Plata. Facultad de Ciencias Exactas y Naturales. Instituto de Investigaciones Marinas y Costeras; ArgentinaFil: Saraceno, Marcos. Comisión Nacional de Energía Atómica; Argentina. Universidad Nacional de San Martín; ArgentinaFil: Jalabert, Rodolfo. Université de Strasbourg; FranciaFil: Roncaglia, Augusto Jose. Universidad de Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Mar del Plata. Instituto de Investigaciones Marinas y Costeras. Subsede Instituto Nacional de Investigación y Desarrollo Pesquero; ArgentinaFil: Wisniacki, Diego Ariel. Universidad de Buenos Aires; Argentin

Low X-Ray Luminosity Galaxy Clusters. II. Optical properties and morphological content at 0.18 < z < 0.70

This is the second of a series of papers on low X-ray luminosity galaxy clusters, in which we present the $r^\prime$, $g^\prime$ and $i^\prime$ photometry obtained with GMOS-IMAGE at Gemini North and South telescopes for seven systems in the redshift range of 0.18 to 0.70. Optical magnitudes, colours and morphological parameters, namely, concentration index, ellipticity and visual morphological classification, are also given. At lower redshifts, the presence of a well-defined red cluster sequence extending by more than 4 magnitudes showed that these intermediate-mass clusters had reached a relaxed stage. This was confirmed by the small fraction of blue galaxy members observed in the central regions of $\sim$ 0.75 Mpc. In contrast, galaxy clusters at higher redshifts had a less important red cluster sequence. We also found that the galaxy radial density profiles in these clusters were well fitted by a single power law. At 0.18 $<$ z $<$ 0.70, we observed an increasing fraction of blue galaxies and a decreasing fraction of lenticulars, with the early-type fraction remaining almost constant. Overall, the results of these intermediate-mass clusters are in agreement with those for high mass clusters.Comment: 16 pages, 13 figures, 5 tables. Accepted for publication in MNRA

Fowler-Nordheim tunneling characterization on Poly1-Poly2 capacitors for the implementation of analog memories in CMOS 0.5 m technology

The experimental results of the Fowler-Nordheim characterization using poly1-poly2 capacitors on CMOS ON Semi 0.5 m technology are presented. This characterization allows the development, design, and characterization of a newcurrent-mode analog nonvolatile memory. Experimental results of the memory cell architecture are presented and demonstrate the usefulness of the proposed architecture

Electrical parameters extraction of CMOS floating-gate inverters

This work provides an accurate methodology for extracting the floating-gate gain factory, of CMOS floating-gate inverters with a clock-driven switch for accessing temporarilly to the floating-gate. With the methodology proposed in this paper, the &#947; factor and other parasitic capacitances coupled to the floating-gate can be easily extracted in a mismatch-free approach. This parameter plays an important role in modern analog and mixed-signal CMOS circuits, since it limits the circuit performance. Theoretical and measured values using two test cells, fabricated in a standard double poly double metal CMOS AMI-ABN process with 1.2 µm design rules, were compared. The extracted parameters can be incorporated into floating-gate PS pice macromodels for obtaining accurate electrical simulation

A large accumulation of avian eggs from the Late Cretaceous of Patagonia (Argentina) reveals a novel nesting strategy in Mesozoic birds

We report the first evidence for a nesting colony of Mesozoic birds on Gondwana: a fossil accumulation in Late Cretaceous rocks mapped and collected from within the campus of the National University of Comahue, Neuquén City, Patagonia (Argentina). Here, Cretaceous ornithothoracine birds, almost certainly Enanthiornithes, nested in an arid, shallow basinal environment among sand dunes close to an ephemeral water-course. We mapped and collected 65 complete, near-complete, and broken eggs across an area of more than 55 m2. These eggs were laid either singly, or occasionally in pairs, onto a sandy substrate. All eggs were found apparently in, or close to, their original nest site; they all occur within the same bedding plane and may represent the product of a single nesting season or a short series of nesting attempts. Although there is no evidence for nesting structures, all but one of the Comahue eggs were half-buried upright in the sand with their pointed end downwards, a position that would have exposed the pole containing the air cell and precluded egg turning. This egg position is not seen in living birds, with the exception of the basal galliform megapodes who place their eggs within mounds of vegetation or burrows. This accumulation reveals a novel nesting behaviour in Mesozoic Aves that was perhaps shared with the non-avian and phylogenetically more basal troodontid theropods.Fil: Fernández, Mariela. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Patagonia Norte. Instituto de Investigación en Biodiversidad y Medioambiente; ArgentinaFil: Garcia, Rodolfo Andres. Universidad Nacional de Rio Negro. Sede Alto Valle. Instituto de Investigaciones En Paleobiologia y Geologia; ArgentinaFil: Fiorelli, Lucas Ernesto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Regional de Investigaciones Cientificas y Transferencia Tecnológica de Anillaco; ArgentinaFil: Scolaro, Jose Alejandro. Universidad Nacional de la Patagonia "san Juan Bosco"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Nacional Patagónico; ArgentinaFil: Salvador, Rodrigo B.. Universidade de Sao Paulo. Instituto Quã­mica de Sao Carlos; BrasilFil: Cotaro, Carlos N.. Comisión Nacional de Energía Atómica. Centro Atómico Bariloche; ArgentinaFil: Kaiser, Gary W.. Royal British Columbia Museum; CanadáFil: Dyke, Gareth J.. University Of Southampton; Reino Unid

4-1BBL as a Mediator of Cross-Talk between Innate, Adaptive, and Regulatory Immunity against Cancer

The ability of tumor cells to evade the immune system is one of the main challenges we confront in the fight against cancer. Multiple strategies have been developed to counteract this situation, including the use of immunostimulant molecules that play a key role in the anti-tumor immune response. Such a response needs to be tumor-specific to cause as little damage as possible to healthy cells and also to track and eliminate disseminated tumor cells. Therefore, the combination of immunostimulant molecules and tumor-associated antigens has been implemented as an antitumor therapy strategy to eliminate the main obstacles confronted in conventional therapies. The immunostimulant 4-1BBL belongs to the tumor necrosis factor (TNF) family and it has been widely reported as the most effective member for activating lymphocytes. Hence, we will review the molecular, pre-clinical, and clinical applications in conjunction with tumor-associated antigens in antitumor immunotherapy, as well as the main molecular pathways involved in this association