Clinical and Immunopathologic Profile of Mexican Patients with IgG4 Autoimmune Pancreatitis

Autoimmune pancreatitis is part of the spectrum of IgG4-associated diseases. Its diagnostic criteria and histological subtypes have been formally proposed recently and although based on current data it has been suggested that there are differences in clinical presentation among populations, more research is needed to properly establish if this heterogeneity exists. In this paper, we describe 15 cases of autoimmune pancreatitis diagnosed at a Mexican centre of reference, all of them associated to the lymphoplasmocytic sclerosing pancreatitis variant. The mean age at the onset of symptoms was 47.5 ± 14.4 years, and 53% of patients were male. The main manifestations were weight loss (87%), obstructive jaundice (53%), and acute (27%) and chronic (27%) pancreatitis. Only 20% of patients had high IgG4 serum levels at the time of diagnosis. All patients receiving prednisone responded favourably, both in their pancreatic and extrapancreatic manifestations. Clinical manifestations of Mexican patients showed certain differences with respect to those usually reported

Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe

Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity

Magnetic fields and radio emission processes in maser-emitting planetary nebulae

We present polarimetric observations of the 4 ground-state transitions of OH, toward a sample of maser-emitting planetary nebulae (PNe) using the Australia Telescope Compact Array. This sample includes confirmed OH-emitting PNe, confirmed and candidate H2O-maser-emitting PNe. Polarimetric observations provide information related to the magnetic field of these sources. Maser-emitting PNe are very young PNe and magnetic fields are a key ingredient in the early evolution and shaping process of PNe. Our preliminary results suggest that magnetic field strengths may change very rapidly in young PNe.© International Astronomical Union 201

Increased Mortality from Extrapancreatic Infections in Hospitalized Patients with Acute Pancreatitis

Nosocomial extrapancreatic infections in patients with acute pancreatitis (AP) are associated with a higher mortality even after adjusting the risk for the severity of the pancreatitis. The aim of this study was to describe the clinical features of hospitalized patients with AP who died during their hospitalization and to evaluate risk factors associated with mortality. We performed a descriptive study of the clinical features of adult patients who died from AP during their hospitalization and a case control study with a paired group of patients that survived AP during a 10-year period. Data of interest were collected from the medical records and are presented with appropriate measures of central tendency and dispersion. For the case control study, the primary outcome evaluated was death, and to evaluate associated clinical features and determine differences between groups, we performed the χ2 or Fisher’s exact tests for categorical variables and the Student t-test or Mann-Whitney U test for continuous variables as appropriate. We found 48 patients with acute pancreatitis who died within the period of the study during hospitalization; from these, 50% were men, mean age was 53.2 years, and the most common etiology was biliary obstruction by gallstones in 45.8%. The global mortality rate was of 2.5%. A total of 43.7% patients had infected pancreatic necrosis, and in 58.3%, some extrapancreatic infection was documented, being the most common urinary tract infection in 50%, bacteremia in 50% and pneumonia in 33.3%. Clinical features associated with mortality were the presence of organ failure (p<0.001), nosocomial complications (p<0.001), infected necrosis (p<0.001), and extrapancreatic infections (p=0.002). From the different extrapancreatic infections, only bacteremia (p=0.001) and pneumonia (p=0.011) were associated with higher mortality. In conclusion, extrapancreatic infections are associated with increased mortality among hospitalized patients with acute pancreatitis, in particular, bacteremia and pneumonia with an isolated pathogen

ALMA imaging of the nascent planetary nebula IRAS 15103-5754

We present continuum and molecular-line (CO, C18O, HCO+) observations carried out with the Atacama Large Millimeter/submillimeter Array toward the 'water fountain' star IRAS 15103-5754, an object that could be the youngest planetary nebula (PN) known. We detect two continuum sources, separated by 0.39 ±0.03 arcsec. The emission from the brighter source seems to arise mainly from ionized gas, thus confirming the PN nature of the object. The molecular-line emission is dominated by a circumstellar torus with a diameter of ~0.6 arcsec (2000 au) and expanding at ~23 km s -1 . We see at least two gas outflows. The highestvelocity outflow (deprojected velocities up to 250 km s -1 ), traced by the CO lines, shows a biconical morphology, whose axis is misaligned ~14° with respect to the symmetry axis of the torus, and with a different central velocity (by ~8 km s -1 ). An additional high-density outflow (traced by HCO+) is oriented nearly perpendicular to the torus. We speculate that IRAS 15103-5754 was a triple stellar system that went through a common envelope phase, and one of the components was ejected in this process. A subsequent low-collimation wind from the remaining binary stripped out gas from the torus, creating the conical outflow. The high velocity of the outflow suggests that the momentum transfer from the wind is extremely efficient, or that we are witnessing a very energetic mass-loss event. © 2018 The Author(s).JFG and LFM are supported by Ministerio de Economia, Industria y Competitividad (MINECO, Spain) grants AYA2014-57369-C3-3 and AYA2017-84390-C2-1-R (co-funded by FEDER). JFG also acknowledges the support of Ministerio de Educacion, Cultura y Deporte (Spain), under the mobility programme for senior scientists at foreign universities and research centres, as well as the hospitality of Universite Cote d'Azur/Laboratoire Lagrange during the preparation of this paper. JRR is supported by grant ESP2015-65597-C4-1-R (MINECO/FEDER). LU acknowledges support from the University of Guanajuato (Mexico) grant ID CIIC 17/2018, and from PRODEP (Mexico). This paper makes use of the following ALMA data: ADS/JAO.ALMA#2015.1.00777.S. ALMA is a partnership of the European Southern Observatory (ESO; representing its member states), the National Science Foundation (USA) and the National Institutes of Natural Sciences (Japan), together with the National Research Council (Canada), the National Science Council and the Academia Sinica Institute of Astronomy and Astrophysics (Taiwan) and the Korea Astronomy and Space Science Institute (Republic of Korea), in cooperation with the Republic of Chile. The Joint ALMA Observatory is operated by the ESO, the Associated Universities, Inc./National Radio Astronomy Observatory and the National Astronomical Observatory of Japan.Peer Reviewe