¿Sigue siendo útil medir el GC mediante el Catéter de Arteria Pulmonar en pacientes críticos?

Koo et al analizan el uso del Catéter de Arteria Pulmonar (CAP) en un estudio longitudinal multicéntrico realizado en las UCIs de la región de Hamilton (Canadá). Para ello incluyen en el estudio todos los pacientes ingresados en las UCIs a los que se les implantó un CAP en los primeros 2 días de ingreso. El estudio abarca un periodo de 5 años. La variable dependiente fue el uso precoz del CAP (inserción en los 2 primeros días de ingreso), lo cual representó el 96,7% de todas las inserciones. Se estudiaron las variables predictoras del uso precoz del CAP que se agruparon en 3 grupos: - Tipo de UCI: UCI-J (incluye pacientes en diálisis crónica, transplante renal e intervenciones de cabeza, cuello y cirugía torácica), UCI-M (pacientes con enfermedades hematológicas y de alto riesgo obstétrico), UCI-H (centro regional del cáncer) y UCI-G (pacientes de neurocirugía, trauma y enfermedades vasculares). - Especialidad básica del médico intensivista: Con respecto a los médicos se incluyeron 24 médicos con experiencia en cuidados críticos y se dividieron en especialidad médica, especialidad quirúrgica, anestesiólogos y “otros intensivistas” (en éste último estaban incluidos médicos que atendían esporádicamente a los pacientes) así como sus años de experiencia. - Tipo de paciente: datos demográficos (edad, sexo, año de ingreso en UCI), tipo de paciente (médico, quirúrgico emergente y quirúrgico electivo), diagnóstico (cardiovascular, respiratorio, séptico, gastrointestinal, neurológico, politrauma, renal, metabólico/tóxico, hematológico y “otros”), variables fisiológicas (APACHE II), criterios de daño renal agudo (Cr sérica > 350 mmol/l o diuresis menor de 21 ml/h por lo menos durante 24 horas) y “otras intervenciones” (ventilación mecánica, tratamiento con vasopresores). No se incluyó a los pacientes a los que se les realizaron intervenciones de cirugía cardíaca y reparaciones de aneurismas de la aorta torácica, ya que en estos casos el CAP fue el estándar de cuidados

A polymorphic microsatellite from the Squalius alburnoides complex (Osteichthyes, Cyprinidae) cloned by serendipity can be useful in genetic analysis of polyploids

A new microsatellite locus (SAS1) for Squalius alburnoides was obtained through cloning by serendipity. The possible usefulness of this new species-specific microsatellite in genetic studies of this hybrid-species complex, was explored. The polymorphism exhibited by SAS1 microsatellite is an important addition to the set of microsatellites previously used in genetic studies in S. alburnoides complex, that mostly relied in markers described for other species. Moreover, the SAS1 microsatellite could be used to identify the parental genomes of the complex, complementing other methods recently described for the same purpose.

Impact of Liver Inflammation on Bile Acid Side Chain Shortening and Amidation

Bile acid (BA) synthesis from cholesterol by hepatocytes is inhibited by inflammatory cytokines. Whether liver inflammation also affects BA side chain shortening and conjugation was investigated. In human liver cell lines (IHH, HepG2, and HepaRG), agonists of nuclear receptors including the farnesoid X receptor (FXR), liver X receptor (LXR), and peroxisome proliferator-activated receptors (PPARs) did not affect the expression of BA-related peroxisomal enzymes. In contrast, hepatocyte nuclear factor 4? (HNF4?) inhibition down-regulated acyl-CoA oxidase 2 (ACOX2). ACOX2 was repressed by fibroblast growth factor 19 (FGF19), which was prevented by extracellular signal-regulated kinase (ERK) pathway inhibition. These changes were paralleled by altered BA synthesis (HPLC-MS/MS). Cytokines able to down-regulate cholesterol-7?-hydroxylase (CYP7A1) had little effect on peroxisomal enzymes involved in BA synthesis except for ACOX2 and bile acid-CoA:amino acid N-acyltransferase (BAAT), which were down-regulated, mainly by oncostatin M (OSM). This effect was prevented by Janus kinase (JAK) inhibition, which restored BA side chain shortening and conjugation. The binding of OSM to the extracellular matrix accounted for a persistent effect after culture medium replacement. In silico analysis of four databases (n = 201) and a validation cohort (n = 90) revealed an inverse relationship between liver inflammation and ACOX2/BAAT expression which was associated with changes in HNF4? levels. In conclusion, BA side chain shortening and conjugation are inhibited by inflammatory effectors. However, other mechanisms involved in BA homeostasis counterbalance any significant impact on the serum BA profile

Finding needles in haystacks: linking scientific names, reference specimens and molecular data for Fungi

DNA phylogenetic comparisons have shown that morphology-based species recognition often underestimates fungal diversity. Therefore, the need for accurate DNA sequence data, tied to both correct taxonomic names and clearly annotated specimen data, has never been greater. Furthermore, the growing number of molecular ecology and microbiome projects using high-throughput sequencing require fast and effective methods for en masse species assignments. In this article, we focus on selecting and re-annotating a set of marker reference sequences that represent each currently accepted order of Fungi. The particular focus is on sequences from the internal transcribed spacer region in the nuclear ribosomal cistron, derived from type specimens and/or ex-type cultures. Re-annotated and verified sequences were deposited in a curated public database at the National Center for Biotechnology Information (NCBI), namely the RefSeq Targeted Loci (RTL) database, and will be visible during routine sequence similarity searches with NR_prefixed accession numbers. A set of standards and protocols is proposed to improve the data quality of new sequences, and we suggest how type and other reference sequences can be used to improve identification of Fungi

The extraordinary evolutionary history of the reticuloendotheliosis viruses

The reticuloendotheliosis viruses (REVs) comprise several closely related amphotropic retroviruses isolated from birds. These viruses exhibit several highly unusual characteristics that have not so far been adequately explained, including their extremely close relationship to mammalian retroviruses, and their presence as endogenous sequences within the genomes of certain large DNA viruses. We present evidence for an iatrogenic origin of REVs that accounts for these phenomena. Firstly, we identify endogenous retroviral fossils in mammalian genomes that share a unique recombinant structure with REVs—unequivocally demonstrating that REVs derive directly from mammalian retroviruses. Secondly, through sequencing of archived REV isolates, we confirm that contaminated Plasmodium lophurae stocks have been the source of multiple REV outbreaks in experimentally infected birds. Finally, we show that both phylogenetic and historical evidence support a scenario wherein REVs originated as mammalian retroviruses that were accidentally introduced into avian hosts in the late 1930s, during experimental studies of P. lophurae, and subsequently integrated into the fowlpox virus (FWPV) and gallid herpesvirus type 2 (GHV-2) genomes, generating recombinant DNA viruses that now circulate in wild birds and poultry. Our findings provide a novel perspective on the origin and evolution of REV, and indicate that horizontal gene transfer between virus families can expand the impact of iatrogenic transmission events

Longer and less overlapping food webs in anthropogenically disturbed marine ecosystems: confirmations from the past

The human exploitation of marine resources is characterised by the preferential removal of the largest species. Although this is expected to modify the structure of food webs, we have a relatively poor understanding of the potential consequences of such alteration. Here, we take advantage of a collection of ancient consumer tissues, using stable isotope analysis and SIBER to assess changes in the structure of coastal marine food webs in the South-western Atlantic through the second half of the Holocene as a result of the sequential exploitation of marine resources by hunter-gatherers, western sealers and modern fishermen. Samples were collected from shell middens and museums. Shells of both modern and archaeological intertidal herbivorous molluscs were used to reconstruct changes in the stable isotopic baseline, while modern and archaeological bones of the South American sea lion Otaria flavescens, South American fur seal Arctocephalus australis and Magellanic penguin Spheniscus magellanicus were used to analyse changes in the structure of the community of top predators. We found that ancient food webs were shorter, more redundant and more overlapping than current ones, both in northern-central Patagonia and southern Patagonia. These surprising results may be best explained by the huge impact of western sealing on pinnipeds during the fur trade period, rather than the impact of fishing on fish populations. As a consequence, the populations of pinnipeds at the end of the sealing period were likely well below the ecosystem's carrying capacity, which resulted in a release of intraspecific competition and a shift towards larger and higher trophic level prey. This in turn led to longer and less overlapping food webs

Los recursos humanos para la vigilancia en salud pública en el sistema nacional de salud: necesidad de una nueva política

XLI Reunión anual de la Sociedad Española de Epidemiología (SEE) y XVIII Congresso da Associação Portuguesa de Epidemiología (APE). Porto (Portugal), del 5 al 8 de septiembre de 2023.Antecedentes/Objetivos: La Estrategia de Vigilancia en Salud Pública (VSP) del Sistema Nacional de Salud (SNS) y la Declaración de Zaragoza de 2022 sobre VSP establecen la necesidad de una política de recursos humanos que garantice la efectividad y la calidad de la VSP. Uno de los objetivos de la Estrategia es hacer un análisis de la situación de la VSP, y como parte de este análisis, coordinado por el Ministerio de Sanidad se ha realizado un estudio del marco de recursos humanos y formación con la participación de las CC. AA. y el nivel central. Métodos: Encuesta estructurada a CC. AA., MS e ISCIII de enero a marzo de 2023. El estudio se centra en seis ámbitos: 1) Ordenación de personal, 2) Plantillas de recursos humanos en VSP en número y funciones, 3) Retribuciones y desarrollo profesional 4) Formación, 5) Ofertas de empleo público y convocatorias públicas de plazas (OEP) y 6) Mecanismos de refuerzo de plantillas de VSP ante situaciones de alerta. Resultados: Han respondido a la encuesta 16 CC. AA., el MS y el CNE (ISCIII). Los resultados definitivos del estudio estarán disponibles en junio de 2023. Se presentarán resultados sobre los perfiles de los profesionales que trabajan en VSP: número de profesionales (plazas cubiertas dotadas y ocupadas, cubiertas sin dotar, vacantes y cedidas), género, edad, régimen profesional, distribución territorial (local, provincial, autonómico), tipos de plazas que ocupan en el SNS, evolución de estas plazas en los últimos 5 años y formación. Además, se presentarán resultados relativos a las condiciones laborales: carrera profesional, retribuciones y guardias, así como a los distintos mecanismos de ordenación de personal que existen en las administraciones públicas para realizar las funciones de VSP. Conclusiones/Recomendaciones: Como se ha demostrado durante la pandemia de COVID-19, para llevar a cabo una vigilancia de calidad, una prioridad es contar con los recursos humanos adecuados. Para ello, es necesario adecuar las plantillas actuales a los nuevos requerimientos de la VSP, tanto en número de efectivos y capacitación para asumir nuevos retos, como en la incorporación de nuevos perfiles profesionales. Es preciso impulsar una política de recursos humanos en todo el SNS para dar solución a estos déficits y fortalecer la VSP y el desarrollo coordinado en todo el SNS de estructuras de salud pública dotadas de los recursos humanos, tecnológicos y presupuestarios necesarios para el desempeño eficaz de sus funciones.Financiación: estudio financiado con fondos del PRTR.N