Gastric Volvulus

Gastric volvulus is one of the most worrisome complications related to large paraesophageal hernias. It is a medical emergency that requires high index of suspicion and prompt management and operation during the index admission. Here we discuss the pathophysiology and classification of gastric volvulus, clinical and radiological presentation, and treatment options. The approaches described here include endoscopic, laparoscopic, robotic and open. We advocate for the first three approaches and usually save the open approach for certain redo operations or patients with significant adhesions from prior mediastinal or foregut surgeries

Re-evaluating sheet erosion rates in a popular trekking trail located at the Spanish Central System

Degradation of walking tracks, mainly due to sheet erosion associated with hiking activities, damages the natural and recreational value of protected natural areas. Senda Schmidt is a popular trail located on the northern slope of the Sierra de Guadarrama (Central Spanish System), that shows high denudation morphologies on account of accelerated soil-erosion processes basically caused by human influence (trampling by continuous trekking), resulted in exposed roots. Previous works have used dendrogeomorphological methods in this trail to estimate rates of sheet erosion based on the changing morphology of tree rings (from concentric to eccentric) when root is exposed. This study aims to evaluate soil erosion reconstructing the first year of root exposure by analyzing changes in wood anatomical parameters within growth rings. Additionally, different multivariate statistical approaches were used in order to determinate the influence of different environmental factors affecting the variation in velocity of the sheet erosion processes

Profile of Private Hospitals in the Philippines

As a recognition of the valuable role of private sector in the healthcare delivery system, this paper attempts to collate vital information on private hospitals in the Philippines. This paper looks at the different characteristics and structures of private hospitals sector with regard to geographical distribution, services, financing, human resource, and other information needed by policymakers, investors, and other interested stakeholders. To better understand the current health care delivery system in the country, other sections compare private hospitals vis-a-vis government-owned facilities

The Parkinson's disease-associated genes ATP13A2 and SYT11 regulate autophagy via a common pathway.

Forms of Parkinson's disease (PD) are associated with lysosomal and autophagic dysfunction. ATP13A2, which is mutated in some types of early-onset Parkinsonism, has been suggested as a regulator of the autophagy-lysosome pathway. However, little is known about the ATP13A2 effectors and how they regulate this pathway. Here we show that ATP13A2 depletion negatively regulates another PD-associated gene (SYT11) at both transcriptional and post-translational levels. Decreased SYT11 transcription is controlled by a mechanism dependent on MYCBP2-induced ubiquitination of TSC2, which leads to mTORC1 activation and decreased TFEB-mediated transcription of SYT11, while increased protein turnover is regulated by SYT11 ubiquitination and degradation. Both mechanisms account for a decrease in the levels of SYT11, which, in turn, induces lysosomal dysfunction and impaired degradation of autophagosomes. Thus, we propose that ATP13A2 and SYT11 form a new functional network in the regulation of the autophagy-lysosome pathway, which is likely to contribute to forms of PD-associated neurodegeneration.We are grateful to Wellcome Trust (Principal Research Fellowship to DCR (095317/Z/11/Z), Wellcome Trust/MRC Strategic Award in Neurodegeneration, and Wellcome Trust Strategic Grant to Cambridge Institute for Medical Research (100140/Z/12/Z)), Addenbrooke’s Charitable Trust, and FEBS (Long-Term Fellowship to AA) for funding.This is the final version of the article. It first appeared from Nature Publishing Group via https://doi.org/10.1038/ncomms1180

Influence of the electric field on the latent heat of the ferroelectric phase transition in KDP

The specific heat, heat flux (DTA trace) and dielectric constant of KDP ferroelectric crystal have been measured simultaneously for various electric fields with a conduction calorimeter. The specific heat presents a strong anomaly but these simultaneous measurements allow us to evaluate the latent heat accurately. Latent heat decreases with field and the value of critical electric field --that where latent heat disappears-- is estimated to be (0.44\pm0.03) kV/cm. Incidentally, we have measured simultaneously the dielectric permittivity which suggests that latent heat is developed as domains are growing.Comment: 7 pages, 6 figures, ReVTeX, twocolumn format, to appear in J. Phys. Cond. Matte

Genetic polymorphisms located in TGFB1, AGTR1, and VEGFA genes are associated to chronic renal allograft dysfunction

Background: Persistent inflammation and fibrosis have been related to active progression of renal deterioration and reduced survival of kidney transplant. The aim of this study was to determine the impact of single-nucleotide polymorphisms (SNPs) located in regions related to inflammatory and immune processes on the development of chronic renal allograft dysfunction (CRAD). Methods: A retrospective study was carried out on 276 patients who received kidney transplant (KT). SNPs were genotyped via the SNPlex platform. Statistical analysis was performed with SNPstat and regression logistic analyses were adjusted by age and gender of recipients and donors, cold ischemia time and the number of human leukocyte antigen (HLA) mismatches. Results: From 276 patients with KT, 118 were non-CRAD and 158 were CRAD. Three SNPs showed significant associations with CRAD development: rs1800471 in transforming growth factor beta 1 (TGFB1), rs5186 in angiotensin II receptor type 1 (AGTR1), and rs699947 in vascular endothelial growth factor A (VEGFA). GC genotype of rs1800471 was associated with increased odds of CRAD compared to GG genotype (OR=2.65 (95% confidence interval (CI)=1.09; 6.47), p=0.025), as well as AC and AA genotype of rs699947 assuming a dominant model (OR=1.80 (95% CI=1.02; 3.20), p=0.044). Besides, AC and CC genotypes of rs5186 were associated with reduced odds of CRAD assuming a dominant model (OR=0.56 (95% CI=0.33; 0.96), p=0.033). Conclusion: Our findings suggest that three genes related to immunity and inflammation (rs1800471, rs5186 and rs699947) are associated to susceptibility or protection to CRAD, and might have diagnostic utility in predicting the likelihood of developing CRAD.This work was supported by two Grants from Instituto de Salud Carlos III (Ref: PI08/0738 and PI11/00245) and from Junta de Castilla y León (Ref: GRS 234/A/08). MAJs, AFR and MGF are supported by Grants from Instituto de Salud Carlos III, CM10/00105, UIPY-1377/08 and CM09/00031, respectively.S