Nutcracker syndrome combined with IgA Nephropathy: a cause of recurrent hematuria and proteinuria. Case report

The nutcracker syndrome is caused by the obstruction of the left renal vein secondary to its compression between the superior mesenteric artery and the aorta. Clinically, this syndrome manifests with pain, hematuria, varicocele or lower urinary tract symptoms. The prevalence of this syndrome is currently unknown; however, the diagnosis of this condition has increased thanks to the availability of non-invasive studies that allow its recognition. On the other hand, IgA nephropathy is the most common type of glomerular disease worldwide. Almost 15% of the causes of hematuria in children are secondary to this condition. The combination of IgA nephropathy and the nutcracker syndrome is rare. In the current literature, few cases have been described. We described the case of a 9-year-old scholar with hematuria and persistent proteinuria in the course of a purpura of Henoch-Schonlein in whom renal biopsy documented IgA nephropathy. However, during follow-up, due to the persistence of hematuria and proteinuria, in addition to other symptoms, additional studies are carried out confirming a Nutcracker syndrome. It is key in patients with persistent symptoms to rule out the association of these two diseases to avoid unnecessary interventions

Etnohistorias de América Latina y el Caribe

Este es un trabajo colectivo, a partir de una convocatoria abierta, que dio como resultado el libro titulado: Perfiles etnohistóricos en América Latina y el Caribe, que contiene artículos que presentan resultados de investigaciones, reflexiones críticas, teóricas, metodológicas y técnicas de investigación utilizadas en los estudios etnohistóricos del área. El interés de la obra fue generar el debate sobre la articulación de los contextos locales a los procesos de la globalización y sus nexos históricos, políticos, sociales y culturales con América Latina y el Caribe. Es por lo que, en su mayoría, los textos trascienden las barreras geográficas y geopolíticas, y van más allá de los nacionalismos, regionalismos o de las áreas geográficas comúnmente trazadas por las fronteras del Estado nación. Los escritos permiten entender las diversas dinámicas sociales e interrelaciones históricas y geográficas del continente, con el entramado de nexos globales que inciden en la construcción de formas, fronteras e imaginarios particulares de ver, conocer y dominar al “otro” y lo “otro”. El libro está dividido en dos grandes secciones, una Etnohistorias de América Latina, siglos XVI-XX, y la otra Historia, derecho, género y políticas en América Latina, siglos XX y XXI. La primera sección inicia con el artículo denominado, Los Izalcos: Un altépetl complejo registrado por los tlaxcaltecas en 1524, de Hugo Díaz Chávez, Julio César Alvarado Hernández y David Calogero Messana Villafranco. Este artículo aporta a la comprensión de la distribución geográfica de los pueblos nahuas antes de la invasión y ocupación europea, así como, su impronta en las divisiones administrativas actuales

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Tratamientos psicológicos empíricamente apoyados para adultos: Una revisión selectiva

Antecedentes: los tratamientos psicológicos han mostrado su eficacia, efectividad y eficiencia para el abordaje de los trastornos mentales; no obstante, considerando el conocimiento científico generado en los últimos años, no se dispone de trabajos de actualización en español sobre cuáles son los tratamientos psicológicos con respaldo empírico. El objetivo fue realizar una revisión selectiva de los principales tratamientos psicológicos empíricamente apoyados para el abordaje de trastornos mentales en personas adultas. Método: se recogen niveles de evidencia y grados de recomendación en función de los criterios propuestos por el Sistema Nacional de Salud de España (en las Guías de Práctica Clínica) para diferentes trastornos psicológicos. Resultados: los resultados sugieren que los tratamientos psicológicos disponen de apoyo empírico para el abordaje de un amplio elenco de trastornos psicológicos. El grado de apoyo empírico oscila de bajo a alto en función del trastorno psicológico analizado. La revisión sugiere que ciertos campos de intervención necesitan una mayor investigación. Conclusiones: a partir de esta revisión selectiva, los profesionales de la psicología podrán disponer de información rigurosa y actualizada que les permita tomar decisiones informadas a la hora de implementar aquellos procedimientos psicoterapéuticos empíricamente fundamentados en función de las características de las personas que demandan ayuda. Background: Psychological treatments have shown their efficacy, effectiveness, and efficiency in dealing with mental disorders. However, considering the scientific knowledge generated in recent years, in the Spanish context, there are no updating studies about empirically supported psychological treatments. The main goal was to carry out a selective review of the main empirically supported psychological treatments for mental disorders in adults. Method: Levels of evidence and degrees of recommendation were collected based on the criteria proposed by the Spanish National Health System (Clinical Practice Guidelines) for different psychological disorders. Results: The results indicate that psychological treatments have empirical support for the approach to a wide range of psychological disorders. These levels of empirical evidence gathered range from low to high depending on the psychological disorder analysed. The review indicates the existence of certain fields of intervention that need further investigation. Conclusions: Based on this selective review, psychology professionals will be able to have rigorous, up-to-date information that allows them to make informed decisions when implementing empirically based psychotherapeutic procedures based on the characteristics of the people who require help

Ciencia Odontológica 2.0

Libro que muestra avances de la Investigación Odontológica en MéxicoEs para los integrantes de la Red de Investigación en Estomatología (RIE) una enorme alegría presentar el segundo de una serie de 6 libros sobre casos clínicos, revisiones de la literatura e investigaciones. La RIE está integrada por cuerpos académicos de la UAEH, UAEM, UAC y UdeG

Gestión del conocimiento. Perspectiva multidisciplinaria. Volumen 17

El libro “Gestión del Conocimiento. Perspectiva Multidisciplinaria”, Volumen 17 de la Colección Unión Global, es resultado de investigaciones. Los capítulos del libro, son resultados de investigaciones desarrolladas por sus autores. El libro es una publicación internacional, seriada, continua, arbitrada, de acceso abierto a todas las áreas del conocimiento, orientada a contribuir con procesos de gestión del conocimiento científico, tecnológico y humanístico. Con esta colección, se aspira contribuir con el cultivo, la comprensión, la recopilación y la apropiación social del conocimiento en cuanto a patrimonio intangible de la humanidad, con el propósito de hacer aportes con la transformación de las relaciones socioculturales que sustentan la construcción social de los saberes y su reconocimiento como bien público

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Francisco de Santander: la dicotomía del poder, Cartagena y Santa Marta, 1606-1630

"En esta investigación se analizó la dicotomía de lo lícito e ilícito y cómo se trasgredieron las normas y las costumbres en la sociedad de Cartagena y Santa Marta, durante los años 1606 y 1630, enfocada desde el abuso del poder y el contrabando. Se usó la microhistoria y el estudio de caso como herramientas para entender los conflictos existentes en el poder central y local; y el funcionamiento y las desviaciones de la sociedad enmarcadas en una monarquía policéntrica. Este análisis fue posible gracias al uso y estudio de los juicios civiles como fuente de estudio, con lo cual se pudo reconstruir y entender con mayor profundidad la impartición de justicia y a su vez, permitió entender los conflictos presentes en el Nuevo Reino de Granada. Por lo tanto, se llegó a la conclusión que las tensiones que se crearon entre la administración central y la local, en parte se debieron al interés que hubo por el monopolio de actividades ilícitas, y expuso cómo algunos personajes hacían uso de sus jerarquías para acceder a grandes capitales y para obtener más poder, con lo que se libraban de grandes penas impuestas a sus delitos. Además, la lucha de los poderes afectó no solo a las redes de contrabando, también a los habitantes de las gobernaciones. Estas conductas permearon en esferas políticas y sociales, influenciando las decisiones de los mandatarios, en donde primó el bien particular sobre el bien común.""In this investigation, was analyzed the dichotomy between licit and illicit and how the norms and customs were transgressed in Cartagena and Santa Marta society, since the years 1606 and 1630, focused on the abuse of power and contraband. Microhistory and case study were used as tools to understand the existing conflicts in the central and local power; and the functioning and deviations of society in to a polycentric monarchy. This analysis was possible thanks to the use and study of civil trials as a source of study, it was possible to reconstruct and understand the imparting of justice and at the same time allowed to understand the conflicts present in the Nuevo Reino de Granada. Therefore, it was concluded that the tensions that were created between the central and local administration were due to the interest in the monopoly of illicit activities and exposed how some people used their hierarchies to access big capitals and they obtain more power, with them could escaped from punishment imposed on their crimes. In addition, power struggle affected not only the contraband networks, it also dearness the inhabitants of the governorates. These behaviors permeated the political and social spheres, it was influencing the decisions of the leaders, where the welfare in addition, power struggle affected not only the contraband networks, it also dearness the inhabitants of the governorates. These behaviors permeated the political and social spheres, it was influencing the decisions of the leaders, where the self-welfare prevailed over common."Maestría en HistoriaUniversidad Nacional Autónoma de México. Programa de Posgrado en Histori

Molecular basis of Tousled-Like Kinase 2 activation

Tousled-like kinases (TLKs) are required for genome stability and normal development in numerous organisms and have been implicated in breast cancer and intellectual disability. In humans, the similar TLK1 and TLK2 interact with each other and TLK activity enhances ASF1 histone binding and is inhibited by the DNA damage response, although the molecular mechanisms of TLK regulation remain unclear. Here we describe the crystal structure of the TLK2 kinase domain. We show that the coiled-coil domains mediate dimerization and are essential for activation through ordered autophosphorylation that promotes higher order oligomers that locally increase TLK2 activity. We show that TLK2 mutations involved in intellectual disability impair kinase activity, and the docking of several small-molecule inhibitors of TLK activity suggest that the crystal structure will be useful for guiding the rationale design of new inhibition strategies. Together our results provide insights into the structure and molecular regulation of the TLKs.Novo Nordisk Foundation Center for Protein Research is supported fi nancially by the Novo Nordisk Foundation (Grant NNF14CC0001) and the Danish Cancer Foundation for a grant to G.M. T.H.S. is supported by the Ministerio de Economía y Competitividad (MINECO) (BFU2015-68354, Ayudas para incentivar la incorporación estable de doc- tores (IED) 2015 and institutional funding through the Centres of Excellence Severo Ochoa award and from the CERCA Programme of the Catalan Government), S.S.B. by a predoctoral fellowship from Fundacio La Caixa and M.V.P. by a Severo Ochoa FPI predoctoral fellowship (MINECO). P.R. is supported by the Marie Sk ł odowska-Curie European Training Network (ETN) “ TEMPERA. We would like to thank the Protein Production Facility Platform at CPR for the excellent technical assistance, M. Orozco at IRB Barcelona for helping with the initial modelling analysis and also thank the PRO-MS Danish National Mass Spectrometry Platform for Functional Proteomics and the CPR Mass Spectrometry Platform for instrument support and assistance

Ficha. Retos y pedagogía del ejercicio veedor. Memorias de la veeduría Ciudadana al Plan Estratégico de la Comuna Seis Doce de Octubre. Medellín 2012

La Veeduría Ciudadana al Plan Estratégico de la comuna 6 es una herramienta de participación ciudadana cuyo objetivo es contribuir al desarrollo humano integral de los habitantes de la comuna seis de Medellín, por medio del ejercicio de la Veeduría ciudadana a los procesos de gestión y correcta aplicación de los recursos públicos, planes programas y proyectos del Plan Estratégico de la comuna seis.Eje conceptual: s.d Categoría: s.d Subcategoría: s.