Not All Children with Cystic Fibrosis Have Abnormal Esophageal Neutralization during Chemical Clearance of Acid Reflux.

PurposeAcid neutralization during chemical clearance is significantly prolonged in children with cystic fibrosis, compared to symptomatic children without cystic fibrosis. The absence of available reference values impeded identification of abnormal findings within individual patients with and without cystic fibrosis. The present study aimed to test the hypothesis that significantly more children with cystic fibrosis have acid neutralization durations during chemical clearance that fall outside the physiological range.MethodsPublished reference value for acid neutralization duration during chemical clearance (determined using combined impedance/pH monitoring) was used to assess esophageal acid neutralization efficiency during chemical clearance in 16 children with cystic fibrosis (3 to <18 years) and 16 age-matched children without cystic fibrosis.ResultsDuration of acid neutralization during chemical clearance exceeded the upper end of the physiological range in 9 of 16 (56.3%) children with and in 3 of 16 (18.8%) children without cystic fibrosis (p=0.0412). The likelihood ratio for duration indicated that children with cystic fibrosis are 2.1-times more likely to have abnormal acid neutralization during chemical clearance, and children with abnormal acid neutralization during chemical clearance are 1.5-times more likely to have cystic fibrosis.ConclusionSignificantly more (but not all) children with cystic fibrosis have abnormally prolonged esophageal clearance of acid. Children with cystic fibrosis are more likely to have abnormal acid neutralization during chemical clearance. Additional studies involving larger sample sizes are needed to address the importance of genotype, esophageal motility, composition and volume of saliva, and gastric acidity on acid neutralization efficiency in cystic fibrosis children

Cumplimiento de la pena suspendida desde la perspectiva de los abogados en sentencias de lesiones leves, Juzgado Unipersonal Chanchamayo 2019.

La presente investigación tuvo como propósito identificar el nivel de cumplimiento de la pena suspendida en sentencias de lesiones leves. Por lo que se formuló de la siguiente manera ¿Cuál es el nivel de cumplimiento de la pena suspendida en sentencias de lesiones leves, desde la perspectiva de los abogados, Juzgado Unipersonal Chanchamayo 2019? Consecuentemente, describir como se viene cumpliendo este tipo de pena en procesos de lesiones leves, constituyó el objetivo, asimismo; señalar que la aplicación de los requisitos de la pena suspendida establecido en nuestro código penal en su articulado 57° se viene cumpliendo; siendo así, respecto al primer requisito (pena que no supere los cuatro años) en un bajo nivel de cumplimiento, conducta favorable (segundo requisito) se viene cumpliendo medianamente y no ser reincidente o habitual existe un bajo cumplimiento al momento de fundamentar las resoluciones judiciales e imponer al condenado una pena suspendida. El diseño metodológico fue el de descriptivo simple. El instrumento empleado es el de cuestionario. La muestra estuvo conformada por 30 abogados colegiados, que laboran y residen en la provincia de Chanchamayo. Los resultados fueron procesados con el software Ms Excel V. 19, haciendo uso de tablas de frecuencias simples y porcentuales, gráficos de barras simple; finalmente, para efectos de validaciòn, como el instrumento es dicotòmico, se utilizò la prueba KR 20, apoyado por la hoja de càlculo de Excel. Concluyendo que el nivel de cumplimiento de la pena suspendida respecto al segundo presupuesto y sus presuspuestos son medianamente existiendo el afán de cumplir con las exigencias de nuestra legislación a diferencia del primer y tercer requisito que existe un bajo nivel de cumplimiento por parte de los juzgadores al momento de sentenciar. Finalmente, se recomienda: 1.Que las partes procesales perjudicadas por las sentencias de tipo condenas condicionales se encuentran posibilitadas de solicitar la nulidad de la misma, y; 2. se exige a los juzgadores la materialización de una sentencia, con énfasis en el tipo materia de investigación, sujeta a derecho.Tesi

Modular RNA motifs for orthogonal phase separated compartments.

Recent discoveries in biology have highlighted the importance of protein and RNA-based condensates as an alternative to classical membrane-bound organelles. Here, we demonstrate the design of pure RNA condensates from nanostructured, star-shaped RNA motifs. We generate condensates using two different RNA nanostar architectures: multi-stranded nanostars whose binding interactions are programmed via linear overhangs, and single-stranded nanostars whose interactions are programmed via kissing loops. Through systematic sequence design, we demonstrate that both architectures can produce orthogonal (distinct and immiscible) condensates, which can be individually tracked via fluorogenic aptamers. We also show that aptamers make it possible to recruit peptides and proteins to the condensates with high specificity. Successful co-transcriptional formation of condensates from single-stranded nanostars suggests that they may be genetically encoded and produced in living cells. We provide a library of orthogonal RNA condensates that can be modularly customized and offer a route toward creating systems of functional artificial organelles for the task of compartmentalizing molecules and biochemical reactions

Distrofia miotónica de Steinert. Presentación de un caso

Frecuentemente la insuficiencia cardiaca es la consecuencia final de diversas enfermedades cardiovasculares; pero en raros casos no sucede así, ya que se reconocen otras causas menos frecuentes por daño miocárdico. Puede ser el resultado de algunos trastornos genéticos, representados por algunas miocardiopatías, hemoglobinopatías, desórdenes mendelianos de la matriz extracelular y enfermedades neuromusculares. Estas últimas incluyen una enfermedad muy poco frecuente, con herencia autosómica dominante, conocida como distrofia miotónica tipo 1 o enfermedad de Steinert. Esta enfermedad se caracteriza por la variabilidad de su expresión, que incluye afectación cardiaca. Se presenta el caso de un paciente atendido en Servicio de Urgencias y Emergencias, con disnea marcada, insuficiencia cardiaca y sin factores de riesgo cardiovascular identificados. En el examen clínico se constató arritmia, distrofia muscular, calvicie y signos miotónicos. Después de realizar algunos exámenes se concluyó con el diagnóstico de miotonía de Steinert. El interés de esta comunicación radica en que se trata de una enfermedad rara; incluso, puede ser de utilidad en el contexto docente.</p

Canine Filamentous Dermatitis Associated with Borrelia Infection

Background: Although canine clinical manifestations of Lyme disease vary widely, cutaneous manifestations are not well documented in dogs. In contrast, a variety of cutaneous manifestations are reported in human Lyme disease caused by the spirochete Borrelia burgdorferi. A recently recognized dermopathy associated with tickborne illness known as Morgellons disease is characterized by brightly-colored filamentous inclusions and projections detected in ulcerative lesions and under unbroken skin. Recent studies have demonstrated that the dermal filaments are collagen and keratin biofibers produced by epithelial cells in response to spirochetal infection. We now describe a similar filamentous dermatitis in canine Lyme disease. Methods and Results: Nine dogs were found to have cutaneous ulcerative lesions containing embedded or projecting dermal filaments. Spirochetes characterized as Borrelia spp. were detected in skin tissue by culture, histology, immunohistochemistry, polymerase chain reaction (PCR) and gene sequencing performed at five independent laboratories. Borrelia DNA was detected either directly from skin specimens or from cultures inoculated with skin specimens taken from the nine canine study subjects. Amplicon sequences from two canine samples matched gene sequences for Borrelia burgdorferi sensu stricto. PCR amplification failed to detect spirochetes in dermatological specimens from four healthy asymptomatic dogs. Conclusions: Our study provides evidence that a filamentous dermatitis analogous to Morgellons disease may be a manifestation of Lyme disease in domestic dogs

Gastroesophageal reflux in cystic fibrosis across the age spectrum.

Background:Scientific advances have improved longevity in cystic fibrosis (CF) patients and many of these patients can expect to experience age-related gastrointestinal co-morbidities. We aimed to assess the extent to which age might impact gastroesophageal reflux (GER) in patients with CF. Methods:Our esophageal pH-multichannel intraluminal impedance monitoring database was searched for tracings belonging to CF patients ≥2 years old without prior fundoplication and not taking anti-reflux medications immediately prior (within 7 days) and during the study. Tracings were retrospectively analyzed; Impedance and pH variables were evaluated with respect to age and pulmonary function. Results:Twenty-eight patients were enrolled; 16 children (3.1-17.7 years) and 12 adults (18.2-48.9 years). Among pH probe parameters, correlation analysis showed DeMeester score (P=0.011) and number of acid reflux events lasting &gt;5 minutes (P=0.047) to be significantly correlated with age. Age was not significantly correlated with any of the impedance parameters. Age was negatively correlated with baseline impedance (BI) in the distal esophagus (r=-0.424, P=0.023) and BI was negatively correlated with several pH parameters, including reflux index (r=-0.553, P=0.002), number of total acid reflux events (r=-0.576, P=0.001), number of acid reflux events lasting &gt;5 minutes (r=-0.534, P=0.003), and DeMeester score (r=-0.510, P=0.006). Pulmonary function (percent predicted forced expiratory volume in one minute; ppFEV1) was negatively correlated with age (r=-0.494, P=0.0007). The interaction of age and ppFEV1 and any of the reflux parameters, however, was not significant (P&gt;0.05); the strongest evidence for an interaction was found for the number of acid reflux events reaching the proximal esophagus, but this interaction still did not reach statistical significance (P=0.070). Conclusions:In a small cohort, we found evidence that age may be associated with increased acid exposure and that both age and increased acid exposure are associated with reduced BI in the distal esophagus. The negative relationship between pulmonary function and age in our cohort is not related to GER. This pilot study supports the need for esophageal assessment and treatment of GER as standard components of clinical care for an aging CF population

Herida inguinal por cornada de toro. Informe de caso

Introduction: bull horn wounds represent a great challenge for the surgeon because they produce injuries that are very different from those caused by other causes. In recent years, greater specialization has been developed, which has allowed morbidity and mortality to be considerably reduced. In view of having assisted a patient with an injury of this type – of low incidence in our country – it was decided to present this case, for an update on the subject. Objective: to describe the clinical case of a patient with an injury caused by a bull horn. Case presentation: black male patient, 22 years old, with a history of apparent health, who attended the General Surgery service of the “Dr. Antonio Luaces Iraola” and reports having been attacked by a bull that caused a wound in the right inguinal region. Through the physical examination, a wound with a depth of five centimeters was confirmed; The heartbeat of the right femoral artery was visualized, so it was decided to perform urgent surgery. Conclusions: the case addressed is rare in the province of Ciego de Ávila, evidence that, if asepsis and antisepsis measures are reinforced, it is possible to achieve a satisfactory result in the care of this type of injury.Introducción: las heridas por cuerno de toro representan un gran desafío para el cirujano por producir lesiones muy diferentes a las originadas por otras causas. En los últimos años, se ha desarrollado una mayor especialización, lo que ha permitido reducir considerablemente la morbi-mortalidad. A propósito de haber asistido a un paciente con una lesión de este tipo –de poca incidencia en nuestro país– se decide exponer este caso, para la actualización acerca del tema. Objetivo: describir el caso clínico de un paciente con lesión producida por cuerno de toro. Presentación del caso: paciente de raza negra, masculino, de 22 años de edad, con antecedentes de aparente salud, que acude al servicio de Cirugía General del Hospital Provincial Docente “Dr. Antonio Luaces Iraola” y refiere haber sido atacado por un toro que le produjo una herida en la región inguinal derecha. Mediante el examen físico se constata una herida con profundidad de cinco centímetros; se visualizaba el latido de la arteria femoral derecha, por lo que se decidió realizar una intervención quirúrgica urgente. Conclusiones: el caso abordado es poco frecuente en la provincia de Ciego de Ávila, evidencia que, si se refuerzan las medidas de asepsia y antisepsia, es posible lograr un resultado satisfactorio en la atención a este tipo de lesión

REGULATION OF BETA-ADRENOCEPTORS ACTIVITYUSING SYNTHETIC LIGHT-REGULATED MOLECULES

Beta-adrenoceptors (ß-AR) are prototypical G proteincoupled receptors and important pharmacological targets for many diseases. Indeed, a number of approved drugs target these receptors due to their key role on many physiological functions. Among other examples, we encounter ß1-AR antagonists (ß- Blockers), which constitute the first-line therapy for the treatment of heart diseases, and ß2-AR agonists, which act as bronchodilators for the treatment of breathing pathologies. Considering the relevance of these receptors, achieving a reversible and localised control of their activity would provide a powerful tool, both for its research applications and its clinical potential. In this context, photopharmacology arises as a potent approach. Photopharmacology is an emerging field based on the use of synthetic light-regulated molecules to allow reversible spatiotemporal control of target receptors in native tissues. These ligands have the potential to provide a precise and controllable therapeutic action with increased efficacy and reduced side effects. Moreover, the fine regulation on demand of the receptor activation state is of great interest for their study in non-modified cells, tissues and organisms. The present project provides the first proof of concept for beta-adrenoceptor photopharmacology. We first designed and synthesised libraries of lightregulated compounds in order to regulate ß-AR activity with spatiotemporal precision. Subsequent testing highlighted the successful development of compounds with promising pharmacological properties which can be reversibly and irreversibly controlled by light. The discovered molecules enable a fine control of ß-AR in their native environment that will certainly open the door to innovative research procedures and may inspire future personalized therapies targeting these receptors