Ácidos biliares y transaminasas séricas como predictores de complicaciones fetales en gestantes con colestasis intrahepática. Hospital Nacional Alberto Sabogal Sologuren. Callao. 2015 - 2016

Objetivo: Determinar si los ácidos biliares y transaminasas séricas son predictores de complicaciones fetales en gestantes con Colestasis Intrahepática en el Hospital Nacional Alberto Sabogal Sologuren. Material y métodos: Estudio de pruebas diagnósticas, retrospectivo, observacional, en 73 gestantes con colestasis intrahepatica estableciéndose dos grupos de estudio de 43 y 30 gestantes de acuerdo a la presencia o ausencia de complicaciones fetales. Se calculó la sensibilidad, especificidad, valor predictivo positivo y negativo. Se aplicó el test de chi cuadrado y área bajo la curva. Resultados: Los puntos de corte encontrados fueron los siguientes; ácidos biliares séricos: 35.5 umol/L, Alanina aminotransferasa: 56.5 U/L y para Aspartato aminotransferasa 76.5 U/L. La sensibilidad, especificidad, VPP y VPN de los ácidos biliares fueron 76,74%; 90.0%; 91.67%; 91.67% y 72.97% respectivamente. Con respecto a las transaminasas; para la Alanina aminotransferasa se encontró: sensibilidad 55.81%, especificidad: 63.33; VPP: 68.57%; VPN: 50 y en el caso del Aspartato aminotransferasa se obtuvo: sensibilidad: 62.79%, especificidad: 70%, VPP: 75% y VPN: 56.8% y el área bajo la curva para los ácidos biliares de 0.887 Conclusiones: Los ácidos biliares y transaminasas séricas son predictores de complicaciones fetales en gestantes con Colestasis Intrahepática.Objective: To determine if bile acids and serum transaminases are predictors of fetal complications in pregnant women with Intrahepatic Cholestasis at the Alberto Sabogal Sologuren National Hospital. Material and methods: A retrospective, observational study of diagnostic tests in 73 pregnant women with intrahepatic cholestasis, establishing two study groups of 43 and 30 pregnant women according to the presence or absence of fetal complications. Sensitivity, specificity, positive and negative predictive value were calculated. The chi square test and area under the curve were applied. Results: The cut-off points found were as follows; Serum bile acids: 35.5 umol / L, Alanine aminotransferase: 56.5 U / L and for Aspartate aminotransferase 76.5 U / L. The sensitivity, specificity, VPP and NPV of bile acids were 76.74%; 90.0%; 91.67%; 91.67% and 72.97% respectively. With regard to transaminases; For the Alanine aminotransferase was found: sensitivity 55.81%, specificity: 63.33; VPP: 68.57%; VPN: 50 and in the case of Aspartate aminotransferase: sensitivity: 62.79%, specificity: 70%, PPV: 75% and NPV: 56.8% and the area under the curve for bile acids of 0.887 Conclusions: Bile acids and serum transaminases are predictors of fetal complications in pregnant women with Intrahepatic Cholestasis.Tesi

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field