La Unión Europea en la crisis del Líbano o la paradoja entre poder y querer

El conflicto de Oriente Próximo escribió una más de sus tantas páginas el pasado verano. A principios de julio, las milicias de Hezbollah secuestraron a dos soldados israelíes cerca de la frontera del Líbano y se lanzaron cohetes Katiuska hacia el norte de Israel. Este suceso provocó la respuesta armada israelí y el inicio de un largo verano de bombardeos en el sur del Líbano, en los suburbios de Beirut y en el norte de Israel. La escalada bélica se llevó a cabo delante de una comunidad internacional incapaz de responder con contundencia a la desproporcionada respuesta israelí y a los continuos ataques de Hezbollah en el norte de Israel. Por su lado, la Unión Europea evidenció la divergencia de pareceres entre sus 25 estados miembros. Así, mientras que países como Francia, España o Italia criticaban la desproporción de la actuación israelí; Reino Unido o Alemania reconocían a Israel el derecho a la legítima defensa.El conflicte del Pròxim Orient va escriure una més de les seves tantes pàgines el passat estiu. A principis de juliol, les milícies de Hezbollah van segrestar dos soldats israelians prop de la frontera del Líban i es van llançar coets Katiuska cap al nord d'Israel. Aquest succés va provocar la resposta armada israeliana i l'inici d'un llarg estiu de bombardejos al sud del Líban, en els suburbis de Beirut i al nord d'Israel. L'escalada bèl · lica es va dur a terme davant d'una comunitat internacional incapaç de respondre amb contundència a la desproporcionada resposta israeliana i als continus atacs de Hezbollah al nord d'Israel. Per la seva banda, la Unió Europea va evidenciar la divergència de parers entre els seus 25 estats membres. Així, mentre que països com França, Espanya o Itàlia criticaven la desproporció de l'actuació israeliana, Regne Unit o Alemanya reconeixien a Israel el dret a la legítima defensa

The miRNA199a/SIRT1/P300/Yy1/sST2 signaling axis regulates adverse cardiac remodeling following MI.

Left ventricular remodeling following myocardial infarction (MI) is related to adverse outcome. It has been shown that an up-regulation of plasma soluble ST2 (sST2) levels are associated with lower pre-discharge left ventricular (LV) ejection fraction, adverse cardiovascular outcomes and mortality outcome after MI. The mechanisms involved in its modulation are unknown and there is not specific treatment capable of lowering plasma sST2 levels in acute-stage HF. We recently identified Yin-yang 1 (Yy1) as a transcription factor related to circulating soluble ST2 isoform (sST2) expression in infarcted myocardium. However, the underlying mechanisms involved in this process have not been thoroughly elucidated. This study aimed to evaluate the pathophysiological implication of miR-199a-5p in cardiac remodeling and the expression of the soluble ST2 isoform. Myocardial infarction (MI) was induced by permanent ligation of the left anterior coronary artery in C57BL6/J mice that randomly received antimiR199a therapy, antimiR-Ctrl or saline. A model of biomechanical stretching was also used to characterize the underlying mechanisms involved in the activation of Yy1/sST2 axis. Our results show that the significant upregulation of miR-199a-5p after myocardial infarction increases pathological cardiac hypertrophy by upregulating circulating soluble sST2 levels. AntimiR199a therapy up-regulates Sirt1 and inactivates the co-activator P300 protein, thus leading to Yy1 inhibition which decreases both expression and release of circulating sST2 by cardiomyocytes after myocardial infarction. Pharmacological inhibition of miR-199a rescues cardiac hypertrophy and heart failure in mice, offering a potential therapeutic approach for cardiac failure.This study was supported by a grant from the Seneca Foundation-Agency of Science and Technology of the Region of Murcia (20652/JLI/18) and a grant from the Instituto de Salud Carlos III (PI19/00519) which is cofinanced through the European Union's European Regional Development Fund (FEDER). Dr. Lax is a Ramon and Cajal researcher at the Department of Medicine, University of Murcia.S

Description of the bioluminescent emission spectrum of \u3ci\u3eBicellonycha amoena\u3c/i\u3e Gorham, 1880 (Coleoptera: Lampyridae) in Guatemala

Bicellonycha amoena (Gorham, 1880) (Coleoptera: Lampyridae) usually flies one meter above ground level over grass, water, or open areas, where males produce a simple single flash every 2–4 seconds, having their most active flashing period from mid to late dusk and early night. In addition, nothing else is known about the behavior of this species. We conducted field observations at the “Mayan Golf Club” in Guatemala Department, and Santiago Sacatepéquez, Sacatepéquez Department, Guatemala; and analyzed B. amoena flashes with a spectroscope. Fireflies displayed a lime-green bioluminescence color. The male flash­ing activity began ~30 minutes after sunset and lasted approximately 70 minutes. For B. amoena, the spectral composition of the flash is intermediate between those known from twilight-active fireflies and nocturnal-active fireflies. Bicellonycha amoena (Gorham, 1880) (Coleoptera: Lampyridae) por lo general, vuela a un metro del nivel del suelo sobre pasto, agua o áreas abiertas, donde los machos producen un destello simple cada 2–4 segundos, siendo más activos desde que inicia a oscurecer hasta principios de la noche. Además de esto, no se conoce más sobre el comportamiento de esta especie. Realizamos observaciones de campo en el “Mayan Golf Club” en el Departamento de Guatemala, y en Santiago Sacatepéquez, Departamento de Sacatepéquez, Guatemala; y analizamos los destellos de B. amoena con un espectroscopio. Las luciérnagas mostraron un color de bioluminiscencia verde limón. La actividad de destello del macho comenzó ~30 minutos después de la puesta del sol, y duró aproximadamente 70 minutos. Para B. amoena, la composición espectral de s

Interspecies DNA acquisition by a naturally competent Acinetobacter baumannii strain

The human pathogen Acinetobacter baumannii possesses high genetic plasticity and frequently acquires antimicrobial resistance genes. Here we investigated the role of natural transformation in these processes. Genomic DNA from different sources, including from carbapenem-resistant Klebsiella pneumoniae strains, was mixed with A. baumannii A118 cells. Selected transformants were analysed by whole-genome sequencing. In addition, bioinformatics analyses and in silico gene flow prediction were also performed to support the experimental results. Transformant strains included some that became resistant to carbapenems or changed their antimicrobial susceptibility profile. Foreign DNA acquisition was confirmed by whole-genome analysis. The acquired DNA most frequently identified corresponded to mobile genetic elements, antimicrobial resistance genes and operons involved in metabolism. Bioinformatics analyses and in silico gene flow prediction showed continued exchange of genetic material between A. baumannii and K. pneumoniae when they share the same habitat. Natural transformation plays an important role in the plasticity of A. baumannii and concomitantly in the emergence of multidrug-resistant strains.Fil: Traglia, German Matias. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Place, Kori. California State University; Estados UnidosFil: Dotto, Cristian Marcelo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones en Microbiología y Parasitología Médica. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones en Microbiología y Parasitología Médica; ArgentinaFil: Fernandez, Jennifer. California State University; Estados UnidosFil: Montaña, Sabrina Daiana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones en Microbiología y Parasitología Médica. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones en Microbiología y Parasitología Médica; ArgentinaFil: Bahiense, Camila dos Santos. California State University; Estados UnidosFil: Soler Bistue, Alfonso J. C.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Investigaciones Biotecnológicas. Universidad Nacional de San Martín. Instituto de Investigaciones Biotecnológicas; ArgentinaFil: Iriarte, Andres. Universidad de la Republica. Facultad de Medicina; UruguayFil: Perez, Federico. Louis Stokes Cleveland Department Of Veterans Affairs; Estados UnidosFil: Tolmasky, Marcelo E.. California State University; Estados UnidosFil: Bonomo, Robert A.. Louis Stokes Cleveland Department Of Veterans Affairs; Estados UnidosFil: Melano, Roberto Gustavo. Public Health Ontario Laboratories; CanadáFil: Ramirez, Maria Soledad. California State University; Estados Unido

Impact of PEGylation on the degradation and pore organization in Mesoporous Silica Nanoparticles: a study of the inner mesoporous structure in physiologically relevant ionic conditions

The degradation of mesoporous silica nanoparticles (MSNs) in the biological milieu due to silica hydrolysis plays a fundamental role for the delivery of encapsulated drugs and therapeutics. However, little is known on the evolution of the pore arrangement in the MSNs in biologically relevant conditions. Small Angle X-ray scattering (SAXS) studies were performed on unmodified and PEGylated MSNs with a MCM-48 pore structure and average sizes of 140 nm, exposed to simulated body fluid solution (SBF) at pH 7.4 for different time intervals from 30 min to 24 h. Experiments were performed with silica concentrations below, at and over 0.14 mg/mL, the saturation concentration of silica in water at physiological temperature. At silica concentrations of 1 mg/mL (oversaturation), unmodified MSNs show variation in interpore distances over 6 h exposure to SBF, remaining constant thereafter. A decrease in radius of gyration is observed over the same time. Mesoporosity and radius of gyration of unmodified MSNs remain then unchanged up to 24 h. PEGylated MSNs at 1 mg/mL concentration show a broader diffraction peak but no change in the position of the peak is observed following 24 h exposure to SBF. PEGylated MSNs at 0.01 mg/mL show no diffraction peaks already after 30 min exposure to SBF, while at 0.14 mg/mL a small diffraction peak is present after 30 min exposure but disappears after 1 h.Fil: Ramirez, Maria de Los Angeles. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de San Martin. Instituto de Nanosistemas; Argentina. Basque Research and Technology Alliance. CIC biomaGUNE; EspañaFil: Bindini, Elisa. Basque Research and Technology Alliance. CIC biomaGUNE; EspañaFil: Moretti, Paolo. Università Politecnica Delle Marche; ItaliaFil: Soler Illia, Galo Juan de Avila Arturo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de San Martin. Instituto de Nanosistemas; ArgentinaFil: Amenitsch, Heinz. Graz University Of Technology.; AustriaFil: Andreozzi, Patrizia. Università degli Studi di Firenze; Italia. Basque Research and Technology Alliance. CIC biomaGUNE; EspañaFil: Ortore, Maria Grazia. Università Politecnica Delle Marche; ItaliaFil: Moya, Sergio E.. Basque Research and Technology Alliance. CIC biomaGUNE; Españ

Cost-Utility of Mindfulness-Based Stress Reduction for Fibromyalgia versus a Multicomponent Intervention and Usual Care: A 12-Month Randomized Controlled Trial (EUDAIMON Study)

Fibromyalgia (FM) is a prevalent, chronic, disabling, pain syndrome that implies high healthcare costs. Economic evaluations of potentially effective treatments for FM are needed. The aim of this study was to analyze the cost-utility of Mindfulness-Based Stress Reduction (MBSR) as an add-on to treatment-as-usual (TAU) for patients with FM compared to an adjuvant multicomponent intervention (FibroQoL) and to TAU. We performed an economic evaluation alongside a 12 month, randomized, controlled trial; data from 204 (68 per study arm) of the 225 patients (90.1%) were included in the cost-utility analyses, which were conducted both under the government and the public healthcare system perspectives. The main outcome measures were the EuroQol (EQ-5D-5L) for assessing Quality-Adjusted Life Years (QALYs) and improvements in health-related quality of life, and the Client Service Receipt Inventory (CSRI) for estimating direct and indirect costs. Incremental cost-effectiveness ratios (ICERs) were also calculated. Two sensitivity analyses (intention-to-treat, ITT, and per protocol, PPA) were conducted. The results indicated that MBSR achieved a significant reduction in costs compared to the other study arms (p < 0.05 in the completers sample), especially in terms of indirect costs and primary healthcare services. It also produced a significant incremental effect compared to TAU in the ITT sample (Delta QALYs = 0.053, p < 0.05, where QALYs represents quality-adjusted life years). Overall, our findings support the efficiency of MBSR over FibroQoL and TAU specifically within a Spanish public healthcare context

Role of light chain clearance in the recovery of renal function in multiple myeloma: another point of view

Lay Summary This is a retrospective multicenter study that evaluated the effectiveness of intensive haemodialysis (IHD) vs standards dialysis on renal recovery in patients with acute kidney injury (AKI) associated with myeloma multiple (MM). In this paper, we demonstrated that IHD for early light chain reduction was associated with a better renal prognosis. Another finding is the importance of maintenance diuresis as a marker of good prognosis of renal function. To our knowledge few studies have been focused in the comparison between IHD vs standard dialysis in MM patients with AKI. We consider that if we manage to recover the renal function, we achieve a great clinical impact since the patient with chronic kidney disease and especially in hemodialysis, an increased risk of mortality as well as poorer quality of life. Background Acute kidney injury (AKI) in patients with multiple myeloma (MM) requiring renal replacement treatment (RRT) is associated with high morbidity and mortality. Early reduction of serum free light chains (FLC) using both targeted therapy against MM and intensive hemodialysis (IHD) may improve renal outcomes. We evaluated the effectiveness of two different RRT techniques on renal recovery in an MM patient population: standard dialysis procedure vs IHD with either polymethylmethacrylate (PMMA) or hemodiafiltration with endogenous reinfusion (HFR). Methods This was a multicentric retrospective study with severe AKI related to MM, between 2011 and 2018. Twenty-five consecutive patients with AKI secondary to MM requiring RRT were included. Patients that underwent IHD received six dialysis sessions per week during the first 14 days (PMMA vs HFR). All patients were diagnosed with de novo MM or first relapsed MM. Primary outcome was renal recovery defined as dialysis-free at 6 months follow-up. Results A total of 25 patients were included. Seventeen patients received IHD and eight standard dialysis. All patients were treated with targeted therapy, 84% bortezomib-based. Of the 25 patients included, 14 (56%) became dialysis independent. We observed a higher proportion of patients who received IHD in the group who recovered kidney function compared with those who remained in HD (92.9% vs 36.4%, P = .007). In our study, the use of IHD to remove FLC had a statistically significant association with renal recovery compared with the standard dialysis group (P = .024). Conclusion Early reduction of FLC with IHD as an adjuvant treatment along with MM-targeted therapy may exert a positive impact on renal recovery

Improvement of diabetic retinopathy screening of diabetic patients seen at the Internal Medicine Clinic​​

Diabetic retinopathy (DR) is a leading cause of vision loss globally. The International Diabetes Federation (IDF) estimated the global population with diabetes to be 463 million in 2019 and 700 million in 2045. Retinopathy is a highly specific neurovascular complication of both type 1 and types 2 diabetes, and the prevalence strongly correlates to both the duration of diabetes and the level of glycemic control. Regular follow-up with early detection and treatment of vision-threatening retinopathy enables the prevention of up to 98% of visual loss due to diabetic retinopathy