Clinical Review: Gene-based therapies for ALI/ARDS: where are we now?

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) confer substantial morbidity and mortality, and have no specific therapy. The accessibility of the distal lung epithelium via the airway route, and the relatively transient nature of ALI/ARDS, suggest that the disease may be amenable to gene-based therapies. Ongoing advances in our understanding of the pathophysiology of ALI/ARDS have revealed multiple therapeutic targets for gene-based approaches. Strategies to enhance or restore lung epithelial and/or endothelial cell function, to strengthen lung defense mechanisms against injury, to speed clearance of infection and to enhance the repair process following ALI/ARDS have all demonstrated promise in preclinical models. Despite three decades of gene therapy research, however, the clinical potential for gene-based approaches to lung diseases including ALI/ARDS remains to be realized. Multiple barriers to effective pulmonary gene therapy exist, including the pulmonary architecture, pulmonary defense mechanisms against inhaled particles, the immunogenicity of viral vectors and the poor transfection efficiency of nonviral delivery methods. Deficits remain in our knowledge regarding the optimal molecular targets for gene-based approaches. Encouragingly, recent progress in overcoming these barriers offers hope for the successful translation of gene-based approaches for ALI/ARDS to the clinical setting

EL ENVEJECIMIENTO DEMOGRÁFICO EN MÉXICO Y SU IMPACTO EN EL SECTOR SALUD. 2030-2050

Capítulo I se da a conocer y/o reafirmar tanto las teorías como los términos más usados durante la investigación con la finalidad de obtener mayor familiaridad con estos conceptos, lo cual facilitará la realización y compresión de esta investigación. Capítulo II será importante conocer cómo se fue desarrollando el crecimiento de la población mexicana década por década y de igual manera se analizaran los factores que influyeron en ella. La comprensión de esta información será de gran utilidad debido a que gracias a los datos que se han recabado, se podrá dar un informe más preciso sobre la situación poblacional que enfrentará México en los siguientes años. Capítulo III se realizará un modelo de regresión lineal, el cual va a permitir calcular el Número de Casos de Enfermedades en Personas Adultas Mayores tomando en cuenta las principales enfermed

Social representations of the diet in patients with diabetes mellitus

The "diet" is part of the collective’s worldview, where culture shapes the webs of significance, giving way to a collective ideology internalised in each individual, which is fully accepted, assigned and assimilated by the collective. The diabetes mellitus is a condition whose importance lies in being one of the main causes of morbidity and mortality worldwide. This pathology is complex, but their struggle leads to the most basic and elemental: the "diet". Methodology: Explore the common sense in relation to "diet" in patients with diabetes mellitus, via the Theory of Social Representations (SR). Semi-structured surveys were applied to 100 patients in three units of the Mexican Institute of Social Security of the State of Mexico, to define on the basis of the diabetic patients to the "diet". Results: The term "diet" is a social construct, which builds and reinforces a social reality: poverty, inequality, and decontextualized biomedical control and public policies without social inclusive. Conclusion: The end of this research reveals the thin threads of marginalization and ignomia of our collective suffering from diabetes, expose a inequality and insecurity, perpetuating a "diet" desregionalizada inadequate, contextualized, and far from the truth

Diagnosis and distribution of Citrus tristeza virus in northern Veracruz, Mexico

In the last three years, citrus trees have died at an alarming rate and producers in northern Veracruz relate this to the previous yellowing of the plants. The objective of the research was to know the relationship of CTV with the yellowing and death of citrus trees; the presence of the virus was diagnosed in seven citrus-producing municipalities in the north of Veracruz. 804 samples of citrus trees were collected in 90 locations in the municipalities of Álamo, Castillo de Teayo, Cazones, Chicontepec, Ixhuatlán, Papantla and Tihuatlán. Of the total samples, 380 were positive for CTV; 68% corresponded to weak variants and 40% to severe type. In all municipalities the following symptoms were observed: death of branches (68%), yellowing of shoots (41%), trees with small leaves and barking of the trunk had values of 38 and 32% respectively, with small fruits. years the incidence was 31%, finally, generalized yellowing (19%). For the management of the disease there are various alternatives, the most used is the use of tolerant rootstocks, however, with the existence of severe variants even with tolerant rootstocks there may be death of trees, so it is necessary to look for and implement other more far-reaching options. The results show that even with the regulations that regulate the production and mobilization of plants, the virus is widely distributed in the seven municipalities of northern Veracruz.Objective: of the research was to know the incidence of CTV to try to associate it with the yellowing and death of citrus trees. Design/ Methodology/ Approach: the presence of the virus was diagnosed in seven citrus-producing municipalities in northern Veracruz. A total of 804 samples from citrus trees were collected in 90 locations belonging to the municipalities of Álamo, Castillo de Teayo, Cazones, Chicontepec, Ixhuatlán, Papantla and Tihuatlán. Results: out of all the samples, 380 were positive for CTV; 68% corresponded to attenuated variants and 40% to severe variants. The following symptoms were observed in all the municipalities: death of branches (68%), yellowing of shoots (41%), trees with small leaves (38%), and debarking of the trunk (32%); the incidence of small fruits was 31%, and finally, generalized yellowing (19%). Limitations/ Implications of the study: to manage the disease there are various alternatives, the most frequent is the use of tolerant rootstocks, however, with the existence of severe variants there may be tree deaths even with tolerant rootstocks, so it is necessary to search for and implement other far-reaching options. Findings/ Conclusions: the results show that even with the regulations for the production and mobilization of plants, the virus is widely distributed in the seven municipalities of northern Veracruz

Resposta fotossintética de citros a isolados de Citrus tristeza virus com potencial para proteção cruzada

The objective of this work was to evaluate the photosynthetic response of citrus varieties to the inoculation of isolates T30 and T3 of Citrus tristeza virus (CTV) characterized as having potential to provide cross‑protection against severe CTV isolates in citrus. Citrus plants of 'Campbell' orange, 'Persian' lime, and 'Key' lime were subjected to inoculations by both isolates by patch. Noninoculated plants were used as the control. Symptom expression, photosynthetic and transpiration rates, and stomatal conductance were evaluated by IRGA. Stomatal density and size were evaluated by epidermal impressions. The CTV isolates were also evaluated and molecularly characterized by RT-PCR and Sanger sequencing. 'Campbell' orange and 'Persian' lime plants remained asymptomatic after the inoculations. The inoculation treatments with both CTV isolates did not reduce photosynthetic capacity, transpiration rate, and stomatal conductance, in comparison with the control. Stomatal density and size varied according to the citrus species. T30 and T3 do not affect the photosynthetic responses of 'Campbell' orange and 'Persian' lime; therefore, these isolates have the potential to provide cross-protection to citrus varieties against severe isolates of CTV.O objetivo deste trabalho foi avaliar a resposta fotossintética de variedades de citros submetidas à inoculação dos isolados T30 e T3 de Citrus tristeza virus (CTV) caracterizados como tendo potencial para conferir proteção cruzada a citros contra isolados severos de CTV. Plantas de citros de laranja 'Campbell', limão 'Tahiti' e limão 'Galego' foram submetidas à inoculação de ambos os isolados por “patch”. Plantas não inoculadas foram utilizadas como controle. A expressão dos sintomas,  as taxas fotossintética e de transpiração, e a condutância estomática foram avaliadas por IRGA. A densidade e o tamanho estomáticos foram avaliados por impressões epidérmicas. Os isolados de CTV também foram avaliados e caracterizados molecularmente por RT-PCR e sequenciamento de Sanger. As plantas de laranja 'Campbell' e limão 'Tahiti' permaneceram assintomáticas após as inoculações. Os tratamentos de inoculação com ambos os isolados de CTV não reduziram capacidade fotossintética, taxas de transpiração e condutância estomática, em comparação ao controle. A densidade e o tamanho estomáticos variaram de acordo com a espécie. T30 e T3 não afetam as respostas fotossintéticas de laranja 'Campbell' e limão 'Tahiti'; portanto, estes isolados têm potencial para promover proteção cruzada a variedades de citros contra isolados severos de CTV

Rapid development of interprofessional in situ simulation-based training in response to the COVID-19 outbreak in a tertiary-level hospital in Ireland:Initial response and lessons for future disaster preparation.

INTRODUCTION: The first case of COVID-19 in Ireland was diagnosed on 29 February 2020. Within the same week, our Department of Anaesthesia and Critical Care at University Hospital Galway began to tackle the educational challenge by developing an  in situ interprofessional simulation programme to prepare staff for the impending outbreak. PRINCIPLES AND APPROACHES USED FOR SIMULATION-BASED TRAINING: We describe principles applied to identify core educational and system engineering objectives to prepare healthcare workers (HCWs) for infection control, personal and psychological safety, technical and crisis resource management skills. We discuss application of educational theories, rationale for simulation modes and debriefing techniques. DEVELOPMENT OF THE SIMULATION PROGRAMME: 3 anaesthesia (general, obstetric, paediatric) and 1 critical care silo were created. 13 simulated scenarios were developed for teaching as well as for testing workflows specific to the outbreak. To support HCWs and ensure safety, management guidelines, cognitive aids and checklists were developed using simulation. The cumulative number of HCWs trained in simulation was 750 over a 4-week period. CHALLENGES AND FUTURE DIRECTIONS: Due to the protracted nature of the pandemic, simulation educators should address questions related to sustainability, infection control while delivering simulation, establishment of hybrid programmes and support for psychological preparedness

Discordance between the predictors of clinical and imaging remission in patients with early rheumatoid arthritis in clinical practice: implications for the use of ultrasound within a treatment to target strategy

Objective: To assess the prevalence, relationship between and predictors of clinical and imaging remission in early rheumatoid arthritis (RA), achieved with treat-to-target management in clinical practice. Methods: A prospective observational study was conducted in patients with new-onset RA. The treatment target was remission by disease activity score (DAS28-CRP<2.6). Twelve month outcomes included DAS28-CRP remission, DAS44-CRP remission, ACR/EULAR Boolean remission (BR) and absent or absent/minimal power Doppler activity (PDA) on ultrasound (US) of 26 joints (total PDA score=0 or ≤1, respectively). Logistic regression was conducted to identify baseline predictors of these outcomes. Results: Of 105 patients with complete 12-month data, the rate of DAS28-CRP remission was 43%, DAS44-CRP remission was 39%, BR was 14%, absent PDA was 40% and absent/minimal PDA was 57%. Amongst patients achieving clinical remission defined by DAS28-CRP, DAS44-CRP or BR, absence of PDA was observed in 42%, 44% and 40%, respectively; absent/minimal PDA was detected in 62%, 66% and 67%, respectively. On multivariable analysis, shorter symptom duration, male gender, fewer tender joints and lower disability were associated with the clinical remission definitions. Lack of osteoarthritis predicted absence of PDA and lower total baseline PDA predicted absent/minimal PDA. Conclusion: DAS28-CRP remission and absence of PDA were observed in almost half of patients, but less than a quarter achieved both. Achievement of BR was rare. The low agreement between any of the clinical and imaging outcomes and differences in their predictors highlight the complex interaction between symptoms and synovitis, with implications for treat-to-target management. Long-term follow-up should determine the most appropriate target

Creación del Jardín Infantil Pisquines del municipio de Medellín : formulación del PEI

El Jardín Infantil Pisquines es el resultado de los sueños y aspiraciones empresariales de tres mujeres emprendedoras y apasionadas por la educación, después de muchas experiencias pedagógicas en diferentes Instituciones Educativas, han decidido crear empresa educativa queriendo satisfacer la necesidad que hay en el medio y ofrecer una propuesta pedagógica que genere confianza y seguridad a las familias. Durante el año 2013 y 2014 las creadoras de este proyecto, logran tener una mirada gerencial y hacer su proyecto de grado, realizando la propuesta del PEI, buscando cumplir y hacer realidad sus sueños de crear empresa educativa y gracias a la asesoría y acompañamiento brindado durante la especialización en Gerencia Educativa, fue posible caminar y llegar hacer realidad. Para la realización del marco teórico se tuvieron en cuenta diferentes conceptos como organización escolar; empresa educativa; definición, objetivos y características del PEI; componentes de la gestión educativa, implementada desde la GUIA 34 del MEN las cuales son Gestión directiva, académica, administrativa y de la comunidad. Lo anterior nos permitió abordar y ampliar los conocimientos para la realización de nuestra propuesta Proyecto Educativo Institucional del JARDIN INFANTIL PISQUINES

Benznidazole biotransformation and multiple targets in <i>Trypanosoma</i> cruzi revealed by metabolomics

&lt;b&gt;Background&lt;/b&gt;&lt;p&gt;&lt;/p&gt; The first line treatment for Chagas disease, a neglected tropical disease caused by the protozoan parasite Trypanosoma cruzi, involves administration of benznidazole (Bzn). Bzn is a 2-nitroimidazole pro-drug which requires nitroreduction to become active, although its mode of action is not fully understood. In the present work we used a non-targeted MS-based metabolomics approach to study the metabolic response of T. cruzi to Bzn.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Methodology/Principal findings&lt;/b&gt;&lt;p&gt;&lt;/p&gt; Parasites treated with Bzn were minimally altered compared to untreated trypanosomes, although the redox active thiols trypanothione, homotrypanothione and cysteine were significantly diminished in abundance post-treatment. In addition, multiple Bzn-derived metabolites were detected after treatment. These metabolites included reduction products, fragments and covalent adducts of reduced Bzn linked to each of the major low molecular weight thiols: trypanothione, glutathione, γ-glutamylcysteine, glutathionylspermidine, cysteine and ovothiol A. Bzn products known to be generated in vitro by the unusual trypanosomal nitroreductase, TcNTRI, were found within the parasites, but low molecular weight adducts of glyoxal, a proposed toxic end-product of NTRI Bzn metabolism, were not detected.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Conclusions/significance&lt;/b&gt;&lt;p&gt;&lt;/p&gt; Our data is indicative of a major role of the thiol binding capacity of Bzn reduction products in the mechanism of Bzn toxicity against T. cruzi

La apreciación estudiantil de los docentes y su relación con el aprovechamiento académico en el Programa Educativo de Químico Farmacéutico Biólogo de la Facultad de Química, UAEM

Actualmente hay un interés creciente por la calidad educativa, en la que concurren diversos aspectos, entre ellos destaca la función docente. Dada la enorme relevancia de la figura del docente, es de interés conocer cuál es la relación que existe entre la apreciación que el alumno tiene de su profesor condicionado por factores como la actuación pedagógica y/o carácter psicológico en sus relaciones tanto profesionales como personales con su aprovechamiento escolar. Para el desarrollo de la investigación se partió del contexto principal en el que tiene lugar la actuación docente: la satisfacción de las demandas o expectativas del alumno a través del proceso Apreciación Estudiantil (AE)