Baja visión y ceguera en la red

Hi ha nombroses pàgines web amb informació relacionada amb baixa visió i ceguesa, la qual cosa suposa un gran avantatge a l'hora de documentar-nos sobre aquest tema. No obstant això, els continguts que s'ofereixen a la xarxa, a vegades provenen de fonts poc fiables i de dubtosa qualitat, cosa que constitueix el seu principal desavantatge. L'objectiu del present estudi és documentar el tipus d'informació publicada a internet, en el marc d'Espanya, sobre baixa visió i ceguesa, i sobre les principals patologies que cursen amb baixa visió, i realitzar una anàlisi de les fonts d'informació trobades, atenent a vuit criteris de qualitat. Per a això, es va realitzar un disseny d'estudi observacional transversal durant els mesos compresos entre setembre de 2016 i febrer de 2017, llançant al cercador Google Espanya les paraules clau que van guiar la cerca. Inicialment es van seleccionar un total de 69 pàgines web utilitzant com a paraula clau "baixa visió i ceguesa" (en espanyol), excloent aquelles que operaven fora del territori Espanyol per obtenir una definició correcta i poder desenvolupar el treball. Posteriorment es va realitzar una recerca referida a termes més concrets: “baixa visió”, “centres de baixa visió i ceguesa”, “albinisme”, “DMAE”, “glaucoma”, “miopia magna”, “retinopatía diabètica”, “retinosi pigmentària” i “malaltia de Stargardt”. Es van incloure les 25 primeres pàgines web de cadascuna de les paraules clau, i després d'aplicar diversos criteris d'exclusió, es van seleccionar un total de 225 pàgines web. Després de la recerca genèrica, es va obtenir que el 13% de les 69 pàgines visitades presentaven algun tipus de segell de qualitat o acreditació, però en la cerca per termes concrets aquest percentatge es va elevar al 30%. Una altra dada important ens l’aporten els enllaços avalats per institucions, mitjans de comunicació o marques, el criteri per si mateix pot ser també utilitzat com a criteri de qualitat, i es compleix en un 48% dels enllaços. D'altra banda, el 18% de les 225 pàgines seleccionades compleix amb 7 o 8 criteris de qualitat, i el 57% compleixen amb 5 o més criteris

Caracterización funcional del factor de transcripción Wor1 y su implicación en la adaptación al estado comensal en el patógeno oportunista Candida Albicans

C. albicans es un microorganismo comensal, pero también un patógeno oportunista que produce infecciones superficiales y, en situaciones más graves, infecciones sistémicas que presentan una elevada tasa de mortalidad. Dado el origen endógeno de muchas de estas infecciones diseminadas, existe un interés creciente por determinar los factores permiten que este hongo se establezca como comensal. En el tracto gastrointestinal (TGI) el hongo se expone a señales y condiciones que generan una respuesta adaptativa esencial para su establecimiento. Uno de estos cambios es un aumento de la expresión de WOR1 (White-Opaque Regulator 1), el principal factor de transcripción que regula la transición de célula blanca a célula opaca, pero que también participa en la transición epigenética que sufren estas células tras su paso por el TGI. Conocer qué factores podrían estar regulando el estado comensal resulta fundamental para diseñar nuevas estrategias para prevenir y combatir las infecciones causadas por este hongo..

The Glyoxylate Cycle Is Involved in White-Opaque Switching in Candida albicans

Candida albicans is a commensal yeast that inhabits the gastrointestinal tract of humans. The master regulator of the white-opaque transition WOR1 has been implicated in the adaptation to this commensal status. A proteomic analysis of cells overexpressing this transcription factor (WOR1OE) suggested an altered metabolism of carbon sources and a phenotypic analysis confirmed this alteration. The WOR1OE cells are deficient in using trehalose and xylose and are unable to use 2C sources, which is consistent with a reduction in the amount of Icl1, the isocitrate lyase enzyme. The icl1∆/∆ mutants overexpressing WOR1 are deficient in the production of phloxine B positive cells, a main characteristic of opaque cells, a phenotype also observed in mating type hemizygous mtla1∆ icl1∆/∆ cells, suggesting the involvement of Icl1 in the adaptation to the commensal state. In fact, icl1∆/∆ cells have reduced fitness in mouse gastrointestinal tract as compared with essentially isogenic heterozygous ICL1/icl1∆, but overproduction of WOR1 in an icl1∆/∆ mutant does not restore fitness. These results implicate the glyoxylate shunt in the adaptation to commensalism of C. albicans by mechanisms that are partially independent of WOR1

Identification of Clinical Isolates of Candida albicans with Increased Fitness in Colonization of the Murine Gut

The commensal and opportunistic pathogen Candida albicans is an important cause of fungal diseases in humans, with the gastrointestinal tract being an important reservoir for its infections. The study of the mechanisms promoting the C. albicans commensal state has attracted considerable attention over the last few years, and several studies have focused on the identification of the intestinal human mycobiota and the characterization of Candida genes involved in its establishment as a commensal. In this work, we have barcoded 114 clinical C. albicans isolates to identify strains with an enhanced fitness in a murine gastrointestinal commensalism model. The 114 barcoded clinical isolates were pooled in four groups of 28 to 30 strains that were inoculated by gavage in mice previously treated with antibacterial therapy. Eight strains that either exhibited higher colonization load and/or remained in the gut after antibiotic removal were selected. The phenotypic analysis of these strains compared to an RFP-tagged SC5314 wild type strain did not reveal any specific trait associated with its increased colonization; all strains were able to filament and six of the eight strains displayed invasive growth on Spider medium. Analysis of one of these strains, CaORAL3, revealed that although mice required previous bacterial microbiota reduction with antibiotics to be able to be colonized, removal of this procedure could take place the same day (or even before) Candida inoculation. This strain was able to colonize the intestine of mice already colonized with Candida without antibiotic treatment in co-housing experiments. CaORAL3 was also able to be established as a commensal in mice previously colonized by another (CaHG43) or the same (CaORAL3) C. albicans strain. Therefore, we have identified C. albicans isolates that display higher colonization load than the standard strain SC5314 which will surely facilitate the analysis of the factors that regulate fungal colonization

Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients.OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference.DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries.MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg-1 or less predicted bodyweight (PBW). A VT was deemed 'default' if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation.RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg-1 PBW, P < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P < 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT.CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223

The defective gut colonization of Candida albicans hog1 MAPK mutants is restored by overexpressing the transcriptional regulator of the white opaque transition WOR1

ABSTRACTThe transcriptional master regulator of the white opaque transition of Candida albicans WOR1 is important for the adaptation to the commensal lifestyle in the mammalian gut, a major source of invasive candidiasis. We have generated cells that overproduce Wor1 in mutants defective in the Hog1 MAP kinase, defective in several stress responses and unable to colonize the mice gut. WOR1 overexpression allows hog1 to be established as a commensal in the murine gut in a commensalism model and even compete with wild-type C. albicans cells for establishment. This increased fitness correlates with an enhanced ability to adhere to biotic surfaces as well as increased proteinase and phospholipase production and a decrease in filamentation in vitro. We also show that hog1 WOR1OE are avirulent in a systemic candidiasis model in mice

Overexpression of the White Opaque Switching Master Regulator Wor1 Alters Lipid Metabolism and Mitochondrial Function in Candida albicans

Candida albicans is a commensal yeast that inhabits the gastrointestinal tract of humans; increased colonization of this yeast in this niche has implicated the master regulator of the white-opaque transition, Wor1, by mechanisms not completely understood. We have addressed the role that this transcription factor has on commensalism by the characterization of strains overexpressing this gene. We show that WOR1 overexpression causes an alteration of the total lipid content of the fungal cell and significantly alters the composition of structural and reserve molecular species lipids as determined by lipidomic analysis. These cells are hypersensitive to membrane-disturbing agents such as SDS, have increased tolerance to azoles, an augmented number of peroxisomes, and increased phospholipase activity. WOR1 overexpression also decreases mitochondrial activity and results in altered susceptibility to certain oxidants. All together, these changes reflect drastic alterations in the cellular physiology that facilitate adaptation to the gastrointestinal tract environment.Work in our laboratory is funded by grants PID2021-122648NB-I00 from Ministerio de Ciencia, Innovación y Universidades, InGEMICS (B2017/BMD-3691) and PR38/21-32 ANTICIPA-CM from CAM.Peer reviewe

Deletion of the SKO1 Gene in a hog1 Mutant Reverts Virulence in Candida albicans

Candida albicans displays the ability to adapt to a wide variety of environmental conditions, triggering signaling pathways and transcriptional regulation. Sko1 is a transcription factor that was previously involved in early hypoxic response, cell wall remodeling, and stress response. In the present work, the role of sko1 mutant in in vivo and ex vivo studies was explored. The sko1 mutant behaved as its parental wild type strain regarding the ability to colonize murine intestinal tract, ex vivo adhesion to murine gut epithelium, or systemic virulence. These observations suggest that Sko1 is expendable during commensalism or pathogenesis. Nevertheless, the study of the hog1 sko1 double mutant showed unexpected phenotypes. Previous researches reported that the deletion of the HOG1 gene led to avirulent C. albicans mutant cell, which was, therefore, unable to establish as a commensal in a gastrointestinal murine model. Here, we show that the deletion of sko1 in a hog1 background reverted the virulence of the hog1 mutant in a systemic infection model in Galleria mellonella larvae and slightly improved the ability to colonize the murine gut in a commensalism animal model compared to the hog1 mutant. These results indicate that Sko1 acts as a repressor of virulence related genes, concluding that Sko1 plays a relevant role during commensalism and systemic infection

Propuesta de intervención educativa centrada en el alumno mediante el modelo de clase invertida en la docencia práctica de la asignatura Microbiología Clínica

Hemos implementado la metodología de clase invertida como modelo de aprendizaje centrado en el alumno en la docencia práctica de la asignatura Microbiología Clínica con el objetivo dinamizar y optimizar el tiempo en el aula. Este tipo de docencia ha favorecido la participación activa del estudiante, su aprendizaje y fomentado un mayor pensamiento crítico que permite la toma de decisiones durante la consecución de las prácticas