Clinical and therapeutic implications of epstein-barr virus in hiv-related lymphomas

Altres ajuts: Gilead Sciences (GLD19/00121)The incidence of lymphomas is increased in people living with HIV (PLWH). Aggressive B-cell non-Hodgkin lymphomas (NHLs) are the most common and are considered an AIDS-defining cancer (ADC). Although Hodgkin lymphoma (HL) is not considered an ADC, its incidence is also increased in PLWH. Among all HIV-related lymphomas (HRL), the prevalence of Epstein-Barr virus (EBV) is high. It has been shown that EBV is involved in different lymphomagenic mechanisms mediated by some of its proteins, contributing to the development of different lymphoma subtypes. Additionally, cooperation between both HIV and EBV can lead to the proliferation of aberrant B-cells, thereby being an additional lymphomagenic mechanism in EBV-associated HRL. Despite the close relationship between EBV and HRL, the impact of EBV on clinical aspects has not been extensively studied. These lymphomas are treated with the same therapeutic regimens as the general population in combination with cART. Nevertheless, new therapeutic strategies targeting EBV are promising for these lymphomas. In this article, the different types of HRL are extensively reviewed, focusing on the influence of EBV on the epidemiology, pathogenesis, clinical presentation, and pathological characteristics of each lymphoma subtype. Moreover, novel therapies targeting EBV and future strategies to treat HRL harboring EBV are discussed

Obstetric outcomes during delivery hospitalizations among obese pregnant women in the United States

The rates of both maternal and fetal adverse outcomes increase significantly with higher body mass index. The aim of this study was to calculate national estimates of adverse maternal and fetal outcomes and associated hospitalization cost among obese pregnant women using a national database. This study was a retrospective analysis of data retrieved from Nationwide Inpatient Sample database, collected during 2010–2014. The primary outcomes of this study were adverse maternal and fetal outcomes, hospital length of stay, and hospitalization cost. There was a total of 18,687,217 delivery-related hospitalizations, of which 1,048,323 were among obese women. Obese women were more likely to have cesarean deliveries (aOR 1.70, 95% CI 1.62–1.79) and labor inductions (aOR 1.51, 95% CI 1.42–1.60), greater length of stay after cesarean deliveries (aOR 1.14, 95% CI 1.08–1.36) and vaginal deliveries (aOR 1.48, 95% CI 1.23–1.77). They were also more likely to have pregnancy-related hypertension, preeclampsia, gestational diabetes, premature rupture of membranes, chorioamnionitis, venous thromboembolism, excessive fetal growth, and fetal distress. Obese pregnant women had significantly greater risk for adverse obstetrical outcomes, which substantially increased the hospital and economic burden. Risk stratification of pregnant patients based on obesity could also help obstetricians to make better clinical decisions and improve patient outcomes

La impulsividad como factor determinante en el estado civil de estudiantes universitarios

Impulsivity is associated with several factors, in human behavior, so that in the present work it is carried out as an objective of identifying impulsivity in the university population that allows establishing the direct relationship with marital status in students. In the methodological design, the strategy is established, same as through the use of cross-sectional, non-experimental correlational research of a bibliographic field documentary type. In a population made up of 882 students, which belongs to 241 females and 641 males, it allowed the use of techniques such as the sociodemographic questionnaire, the Ramón y Cajal Impulse Control Scale (ECIRyC), which allowed to generate in their results, that of the total number of attendees, the percentage results are described with the following variables, the singles with (96%) being the largest group in terms of marital status, followed by those who said being married or in a free union corresponding to (2%), while the variables with a lower result were: commitment, divorce, dominant and currently in a relationship with a total of (0%), finally it can be stated that no differences were found in impulsivity and marital status in the participants, since in both cases impulsivity is most prevalent in subjects with separate marital status.La impulsividad se asocia a varios factores, en el comportamiento humano, de manera que en el presente trabajo se realiza como objetivo de identificar la impulsividad en la población universitaria que permitan establecer la relación directa con el estado civil en estudiantes, en el diseño metodológico se establece la estrategia, misma que mediante el uso de la investigación transversal, no experimental correlacional de tipo documental bibliográfico de campo.  En una población constituida por 882 estudiantes, misma que pertenece a 241 femeninos y 641 masculinos permitió la utilización de técnicas como el cuestionario socio demográfico, la Escala de Control del Impulso Ramón y Cajal (ECIRyC), lo que permitió generar en sus resultados, que  del total de participantes asistentes se describen los resultados porcentuales con las siguientes variables, los solteros con el (96%) siendo el grupo más grande en cuanto al estado civil, seguido de los que dijeron estar casados o unión libre correspondiendo al (2%), mientras que las variables con un menor resultado fueron: compromiso, divorcio, dominante y actualmente en pareja con un total de (0%), finalmente se puede referir que no se encontraron diferencias en impulsividad y estado civil en los participantes, puesto que en ambos casos los que más prevalece la impulsividad es en sujetos de estado civil separado

Cultural Competency Observation Tool

This observational assessment rubric includes rating of the elements of patient centered communication defined in the Kalamazoo Consensus Statement regarding patient centered communication: These are augmented with sections that highlight factors that emerged in our observations specific to intercultural communication such as language and interpreters, nonverbal communication, mental and social issues with a large cultural overlay (mental health, pain, and disability). In addition, the tool incorporates issues specific to the medical context such as professional competence and professional regard. The rubric is also informed by the developmental model of intercultural sensitivity and Dreyfus\u27s phenomenology of skill acquisition with skill levels progressing through the stages: novice, beginner, competence, proficient, mastery

Liver-specific insulin receptor isoform A expression enhances hepatic glucose uptake and ameliorates liver steatosis in a mouse model of diet-induced obesity

Among the main complications associated with obesity are insulin resistance and altered glucose and lipid metabolism within the liver. It has previously been described that insulin receptor isoform A (IRA) favors glucose uptake and glycogen storage in hepatocytes compared with isoform B (IRB), improving glucose homeostasis in mice lacking liver insulin receptor. Thus, we hypothesized that IRA could also improve glucose and lipid metabolism in a mouse model of high-fatdiet-induced obesity. We addressed the role of insulin receptor isoforms in glucose and lipid metabolism in vivo. We expressed IRA or IRB specifically in the liver by using adeno-associated viruses (AAVs) in a mouse model of diet-induced insulin resistance and obesity. IRA, but not IRB, expression induced increased glucose uptake in the liver and muscle, improving insulin tolerance. Regarding lipid metabolism, we found that AAV-mediated IRA expression also ameliorated hepatic steatosis by decreasing the expression of Fasn, Pgc1a, Acaca and Dgat2 and increasing Scd-1 expression. Taken together, our results further unravel the role of insulin receptor isoforms in hepatic glucose and lipid metabolism in an insulin-resistant scenario. Our data strongly suggest that IRA is more efficient than IRB at favoring hepatic glucose uptake, improving insulin tolerance and ameliorating hepatic steatosis. Therefore, we conclude that a gene therapy approach for hepatic IRA expression could be a safe and promising tool for the regulation of hepatic glucose consumption and lipid metabolism, two key processes in the development of non-alcoholic fatty liver disease associated with obesity

RhoA downregulation in the murine intestinal epithelium results in chronic Wnt activation and increased tumorigenesis

Cancer; Cell biologyCàncer; Biologia cel·lularCáncer; Biología CelularRho GTPases are molecular switches regulating multiple cellular processes. To investigate the role of RhoA in normal intestinal physiology, we used a conditional mouse model overexpressing a dominant negative RhoA mutant (RhoAT19N) in the intestinal epithelium. Although RhoA inhibition did not cause an overt phenotype, increased levels of nuclear β-catenin were observed in the small intestinal epithelium of RhoAT19N mice, and the overexpression of multiple Wnt target genes revealed a chronic activation of Wnt signaling. Elevated Wnt signaling in RhoAT19N mice and intestinal organoids did not affect the proliferation of intestinal epithelial cells but significantly interfered with their differentiation. Importantly, 17-month-old RhoAT19N mice showed a significant increase in the number of spontaneous intestinal tumors. Altogether, our results indicate that RhoA regulates the differentiation of intestinal epithelial cells and inhibits tumor initiation, likely through the control of Wnt signaling, a key regulator of proliferation and differentiation in the intestine.This work was supported by the IRBLleida Immunohistochemistry and Histology Core Facility. This study was partially funded by grants of Instituto de Salud Carlos III (ISCIII) and co-funded by the European Union (PI19/00993, PI22/00773), European Regional Development Funds (AC19/00095-EuroNanoMed III, AC20/00022-European Joint Program for Rare Diseases), and the Spanish Association Against Cancer (AECC GCA15152966ARAN) to D.A. and grants of Instituto de Salud Carlos III (ISCIII), the European Union (PI23/01062), and Diputació de Lleida (PIRS21/03) to A.M.-B