Persistent confirmed low-grade dysplasia in Barrett's esophagus is a risk factor for progression to high-grade dysplasia and adenocarcinoma in a US Veterans cohort.

Patients with Barrett's esophagus (BE) and low-grade dysplasia (LGD) are at increased risk of esophageal adenocarcinoma (EAC), although many regress to nondysplastic BE. This has significant clinical importance for patients being considered for endoscopic eradication therapy. Our aim is to determine the risk for progression in patients with confirmed persistent LGD. We performed a single-center retrospective cohort study of patients with BE and confirmed LGD between 2006 and 2016. Confirmed LGD was defined as LGD diagnosed by consensus conference with an expert GI pathologist or review by an expert GI pathologist and persistence as LGD present on subsequent endoscopic biopsy. The primary outcome was the incidence rate of HGD (high-grade dysplasia)/EAC. Secondary outcomes included risk factors for dysplastic progression. Risk factors for progression were assessed using univariate and multivariate analysis with logistic regression. Of 69 patients (mean age 65.2 years) with confirmed LGD were included. In total, 16 of 69 patients (23.2%) with LGD developed HGD/EAC during a median follow-up of 3.74 years (IQR, 1.24-5.45). For persistent confirmed LGD, the rate was 6.44 (95% confidence interval (CI), 2.61-13.40) compared to 2.61 cases per 100 patient-years (95% CI, 0.83-6.30) for nonpersistent LGD. Persistent LGD was found in only 29% of patients. Persistent LGD was an independent risk factor for the development of HGD/EAC (OR 4.18; [95% CI, 1.03-17.1]). Persistent confirmed LGD, present in only 1/3 of patients, was an independent risk factor for the development of HGD/EAC. Persistence LGD may be useful in decision making regarding the management of BE.

Genome sequence of a divergent Colombian isolate of potato virus V (PVV) infecting Solanum phureja.

Deep sequencing analysis of the transcriptome of a Solanum phureja cv. Criolla Colombia plant with symptoms typical of a virus disease revealed an infection with potato virus V (PVV). The PVV-phureja genome comprises 9904 nt, exhibits 83% nucleotide identity with currently fully sequenced PVV isolates and contains one large ORF that codes for a polyprotein of 3065 residues flanked by 5' and 3' UTR of 217 and 448 nt, respectively. Phylogenetic analysis of the PVV-phureja polyprotein indicates that it is divergent with respect to most PVV isolates. This is the first complete PVV genome of an isolate infecting a host different to S. tuberosum and, to this date, the only one from the South American Andes.

Genetic variation in fertility of heat-stressed male mice.

The damaging effects of heat stress on male fertility are evident in developing spermatozoa expressed in ejaculates 18-28 days post-stress in mice. Our objectives were to: (1) assess genetic variation in fertility of heat-stressed male mice and (2) determine response to selection for fertility after heat stress in male mice. Mature male mice were exposed to heat stress (35+/-1 degrees C; n=50) or control (21+/-1 degrees C; n=10) conditions for 24h (day 0) and then hemicastrated for tissue collection. Two periods of mating tests followed, period 1 (from days 3 to 11) when no reductions in fertility were anticipated, and period 2 (days 18-26) when variation in fertility was expected. Period 2 pregnant females were sacrificed in late gestation. Males were indexed by multiplying overall mean ovulation rate by pre-implantation survival and number of pregnant period 2 mates. The five highest and five lowest ranking males were identified as heat stress resistant and susceptible, respectively. Resistant males were 61.2units superior in the index, 57.5% greater in pregnancy rate, and 57.6 total fetuses greater than susceptible males. Progeny of resistant sires were superior to progeny of susceptible sires in estimated breeding value by 4.5units for the index, 4.1% for pregnancy rate, and 5.2 fetuses (P<0.0001). Heritability estimates for the index, pregnancy rate, and number of fetuses ranged from 0.09 to 0.13, suggesting male fertility following heat stress is heritable and responds to selection.

Sneddon's syndrome and phospholipid antibodies.

We present a case of Sneddon's syndrome with high titers of antiphospholipid antibodies (APLA), in which the leading symptom was an incapacitating memory defect. MRI revealed vasculitic lesions of the central nervous system (CNS). Therefore immunosuppressive therapy was started with steroids and cyclophosphamide pulses. The transient beneficial effects of such a therapy will be discussed.

Correlated response in placental efficiency in swine selected for an index of components of lifter size.

The objective of this study was to evaluate correlated response in placental efficiency to selection for components of litter size. Fourteen generations of selection had resulted in a difference between lines of three fully formed piglets at birth. Gilts from a line selected for an index of components of litter size (S, n = 33) and a randomly selected control (C, n = 27) were observed at farrowing. At delivery, the umbilical cord of each piglet was double tagged with identically numbered mouse ear tags to allow the piglet's weight to be matched to the corresponding placental weight. Litter size, placental weight, birth weight, and placental vascularity were recorded. Litter size was higher (12.0 +/- 0.7 vs 7.9 +/- 0.7) in S than in C (P < 0.001). Line differences in placental vascularity were not significant with or without adjustment for litter size (P = 0.45 and 0.39, respectively). Correlated response to selection for components of litter size resulted in a reduced birth weight (S 82.6% of C, P < 0.001) and a reduced placental weight (S 90.9% of C, P = 0.11). After adjusting for litter size, line differences in neither placental weight nor birth weight were significant (P = 0.40 and 0.07, respectively), which indicates that the reduction in birth weight was, for the most part, due to the increase in litter size. The result of the difference in the magnitude of the change for both weights was that placental efficiency, measured as the ratio of birth weight:placental weight was 0.43 higher in C (P = 0.05). Adjustment for litter size increased the difference in placental efficiency to 0.52 (P = 0.02). Since a significant difference in litter size favoring the selected line was observed, we hypothesize that this physiological response was achieved through mechanisms other than improved placental efficiency.

Selection for placental efficiency in swine: conceptus development.

The objective of this study was to evaluate correlated responses in conceptus development and traits physiologically relevant for placental function in swine from a selection experiment that resulted in differences in placental weight (PW) and efficiency (PE = birthweight/placental weight). Generation 3, second parity females from 2 lines with a history of selection on an index predicting either high PE (HPE) or low PE (LPE) were mated within line to produce Generation 4 litters for evaluation at d 30, 50, 70, 90, and 110 of gestation (n = 5/line × d combination). Maternal and fetal traits were analyzed by using a model including the fixed effects of line and gestational age, and the random effect of sire within line. Uterine length was not different between lines at any gestational age, but increased (P = 0.06) from 275.0 ± 23.1 cm at d 30 to 338.3 ± 23.3 cm at d 50, and remained relatively unchanged to d 110. Fetal weight was not different between lines from d 30 to 90, but was less (P = 0.02) in HPE than LPE at d 110 (1,280.6 ± 77.0 vs. 1,551.1 ± 75.3 g, respectively). Crown-rump length was not different between lines from d 30 to 70, but tended (P = 0.09) to be longer in HPE than LPE at d 90 (265.8 ± 8.8 vs. 241.2 ± 10.6 mm, respectively) and was shorter (P = 0.04) in HPE than LPE at d 110 (290.6 ± 5.0 vs. 304.9 ± 4.5 mm, respectively). Placental weight increased in both lines from d 30 to 50, at which point it remained relatively unchanged through the rest of pregnancy, except in LPE that showed a second increase from d 90 to 110. As a result, placental weight was not different between lines from d 30 to 90, but was less (P < 0.01) in HPE than LPE at d 110 (244.6 ± 32.3 vs. 379.2 ± 24.5 g, respectively). Line differences in placental efficiency were not significant at any gestational age. Implantation site length increased slowly for both lines from d 30 to 90, where it remained unchanged to d 110. Implantation site area was greater (P < 0.05) in HPE than LPE at d 30 and 50, but was not different between lines for the remainder of pregnancy. These results suggest that in Western breeds, a reduction in placental weight through selection is not accompanied by compensation in placental nutrient transfer and may result in decreased prenatal survival.

Prevalencia, factores de riesgo y características clínicas de la dismenorrea en estudiantes de la Facultad de Enfermería de la Universidad Pontificia Bolivariana / Prevalence, Risk Factors, and Clinical Characteristics of Dysmenorrhea in Students from the School of Nursing at Universidad Pontificia Bolivariana

Objetivo: identificar la prevalencia, factores de riesgo y características clínicas de la dismenorrea en estudiantes de la Facultad de Enfermería de la Universidad Pontificia Bolivariana. Metodología: estudio transversal en el que se aplicó una encuesta anónima a una muestra de 291 estudiantes. La información se procesó en el software SPSS® versión 17.0 (SPSS Inc; Chicago, Illinois, USA). Se realizó un análisis descriptivo de las variables. Para explorar los factores de riesgo se calculó el OR con sus respectivos intervalos de confianza al 95% y se asumió significación estadística con un valor p <0.05. Resultados: la prevalencia fue del 63.6%. La medición del dolor tuvo una mediana de 6 en la escala visual análoga. El problema le alteró las actividades de la vida diaria al 61.6%; le afectó el rendimiento académico al 45.9%; el 35.7% presentó ausentismo. El 24.3% acudió a un servicio de urgencias por el dolor y el 42.7% consultó al médico. El 68.1% consume algún medicamento; el 83.3% se automedica y el 77.8% lo toma por necesidad. El 78.9% considera cuidados especiales como: calor local, bebidas especiales, reposo y masajes. Los factores de riesgo con significancia estadística fueron: sangrado abundante y dismenorrea materna. Conclusiones: los resultados son coherentes con lo reportado en la literatura científica en cuanto a prevalencia, ausentismo, baja consulta médica, automedicación y tratamientos irregulares. Debe realizarse un trabajo para que las estudiantes asuman una actitud activa frente al problema porque actualmente existen buenos recursos terapéuticos.

Objective: To identify the prevalence, risk factors, and clinical characteristics of dysmenorrhea in students from the School of Nursing at Universidad Pontificia Bolivariana. Methods: Cross sectional study in which an anonymous survey was applied to a sample of 291 students. The information was processed using SPSS® software version 17.0 (SPSS Inc, Chicago, Illinois, USA). A descriptive analysis of the variables was done. The OR was calculated with its confidence intervals of 95% to explore the risk factors, and a p-value of less than 0.05 was considered to be statistically significant. Results: The prevalence found was 63.6%. The pain measurement had a median of 6 on a visual analog scale. A total of 61.6% of the students with dysmenorrhea suffered from changes in their daily activities; 35.7% were absent and 45.9% experienced a decline in academic performance. 24.3% of the students required emergency services due to pain and 42.7% visited the doctor. Also, 68.1% stated that they take some kind of medicine, 83.3% of whom self-medicate, and 77.8% take them when they feel the need. From the sample, 78.9% consider special treatments for pain, such as local heat, special drinks, rest, and massages. The risk factors with statistical significance included abundant bleeding and maternal dysmenorrhea. Conclusions: The results are similar to those reported in the literature regarding prevalence, absenteeism, low consultation rates, self-medication, and irregular treatment. Further work needs to be done in order to enable students to take an active attitude regarding this issue as there are currently good therapeutic resources.

Objetivo: identificar a prevalência, fatores de risco e características clínicas da dismenorreia em estudantes da Faculdade de Enfermaria da Universidade Pontifícia Bolivariana. Metodologia: estudo cross sectional no qual se aplicou uma enquete anônima a uma mostra de 291 estudantes. A informação se processou no software SPSS® versão 17.0 (SPSS Inc; Chicago, Illinois, USA). Realizou-se uma análise descritiva das variáveis. Para explorar os fatores de risco se calculou o OR com seus respectivos intervalos de confiança ao 95%, assumiu-se significância estatística com um valor p <0.05. Resultados: a prevalência foi de 63.6%. A medição da dor teve uma média de 6 na escala visual análoga. O problema lhe alterou as atividades da vida diária a 61.6%; afetou-lhe o rendimento acadêmico a 45.9%; 35.7% apresentou ausentismo. 24.3% foi a um serviço de urgências pela dor e 42.7% conferiu ao médico. 68.1% consome algum medicamento; 83.3% se automedica e 77.8% os tomada a necessidade. 78.9% considera cuidados especiais como: calor local, bebidas especiais, repouso e massagens. Os fatores de risco com significância estatística foram: sangrado abundante e dismenorreia materna. Conclusões: os resultados são afins ao reportado na literatura científica quanto a prevalência, ausentismo, baixa consulta médica, automedicação e tratamentos irregulares. Deve realizar-se um trabalho para que as estudantes assumam uma atitude ativa frente ao problema pois atualmente existem bons recursos terapêuticos.

Genetic and phenotypic relationships of farrowing and weaning survival to birth and placental weights in pigs.

Data obtained during 4 generations of divergent selection for placental efficiency were used to determine factors influencing survival at farrowing and weaning in litters produced by first-parity females. Data were collected from 193 litters and included records on 2,053 individuals. Farrowing survival (FS) and weaning survival (WS) were considered traits of the piglet and were scored 1 if the individual was alive at a time point or 0 if dead. Estimates of (co)variance components for direct and maternal additive genetic effects for FS and WS were obtained using an animal model and computed with the MTDFREML program. Estimates of direct heritability were 0.16 for FS and 0.18 for WS. Estimates of maternal heritability were 0.14 for FS and 0.10 for WS. Genetic correlation estimates between direct and maternal effects were high and negative for both traits. The direct genetic correlation between FS and WS was 0.92. Variables associated with FS and WS were determined using logistic regression procedures. Birth weight (BRW), placental weight, their interaction, and total born can be used as predictors of survival at farrowing in the absence of estimates of genetic merit for survival. The same model, excluding total number born, was the best model for predicting WS. In the presence of BRW information, placental efficiency did not improve the prediction of survival. While it was clearly disadvantageous for a piglet to be below the litter mean in BRW, being above the mean did not provide a substantial advantage in survival. Results from this analysis suggest that it is possible to select for increased survival at farrowing and at weaning. Information on a piglet's BRW, placental weight, litter average BRW, and deviation from litter average BRW can be used to optimize those values at levels resulting in high survival probability.

Selection for placental efficiency in swine: genetic parameters and trends.

The objectives of this study were to estimate response to divergent selection for an index of placental efficiency in swine, and to evaluate the effect of placental efficiency on litter size. The selection index (SI) included total born (TB), birth weight (BRWT), and placental weight (PW), and was designed to increase in the high line (H) or decrease in the low line (L) the efficiency of the placental function (PE), defined as the ratio BRWT:PW. (Co)variance components were estimated for direct and maternal additive effects by using an animal model with MTDFREML procedures. Estimated breeding values were calculated by using records on individual BRWT (n = 2,111), PW (n = 2,006), PE (n = 1,677), and SI (n = 1,677). Litter traits were evaluated using records on 193 litters. The model included the fixed effects of contemporary group for all traits, with the addition of sex for individual traits and parity for litter traits. Litter was fitted as an uncorrelated random effect for all traits, and TB was used as a linear and quadratic covariate for BRWT, PW, and PE. Direct heritability estimates from single-trait models were 0.03, 0.25, 0.18, 0.11, and 0.08 for BRWT, PW, PE, SI, and TB, respectively. Estimated breeding values were compared between lines by using a model including generation, line within generation, and replicate within line as the error term. Estimates of genetic divergence were 20.7 +/- 2.7 g, 0.24 +/- 0.03, 0.11 +/- 0.02, and 0.07 +/- 0.02 per generation for PW, PE, SI, and TB, respectively (P < 0.01), but divergence was not significant for BRWT. At Generation 4, direct EBV was higher in L than in H for PW (55.9 +/- 8.7 vs. -24.2 +/- 9.5 g, respectively; P < 0.01) and higher in H than in L for PE (0.58 +/- 0.10 vs. -0.35 +/- 0.09 g, respectively; P < 0.01). However, EBV was not different for BRWT, SI, or TB. These results indicate that PW and PE are susceptible to change by genetic selection; however, the correlated response in TB was an unexpected genetic trend toward a higher TB in L of 0.05 +/- 0.01 piglets per generation (P < 0.01).

Tubular toxicity of cyclosporine A and the influence of endothelin-1 in renal cell culture models (LLC-PK1 and MDCK).

To evaluate the effect of cyclosporine A (CyA) at high concentrations (10(-4) and 10(-5) M) and the influence of endothelin-1 (ET-1) at physiological and pharmacological concentrations (10(-14) to 10(-6) M) on epithelial cell function, LLC-PK1 cells were studied as a model of the proximal tubule and MDCK cells as a model of the distal tubule/collecting duct. CyA caused time- and concentration-dependent acute toxicity. In LLC-PK1 cells, CyA caused a decrease in transepithelial resistance, indicating a loss of cell contacts, a release of lactate dehydrogenase (LDH) and villin into the supernatant, suggesting destruction of the apical membrane with loss of brush border, and finally release of uvomorulin, suggesting a disruption of the cell-cell adhesion, the zonula adherens. DNA synthesis, as evaluated by bromodeoxyuridine (BrdU) incorporation, was significantly affected at > or = 10(-5) M CyA. The toxicity of CyA was higher when given from the apical rather than the basolateral compartment. ET-1 alone was without effect, but in combination with CyA, ET-1 significantly enhanced toxicity. The ET-1 effect was partially inhibitable by an ET(B), but not an ET(A), antagonist. Immunofluorescence for alpha-catenin, another protein of the zonula adherens, demonstrated no change in polarity for this protein, and immunoprecipitation of the complex indicated relative stability of the zonula adherens despite loss of cadherin into the supernatant. In MDCK cells the effects were different. CyA was not associated with LDH release, but with an increase in transepithelial resistance, indicating increased paracellular resistance. Morphological alterations were significantly less, but BrdU incorporation was decreased. This pattern of toxicity is compatible with a direct toxic effect of CyA on cells of the proximal tubule, with predominant morphological destruction of the cells, with concomitant proximal tubular dysfunction, and a functional alteration in cells of the distal tubule associated with increased paracellular resistance, which may lead to solute and water loss.

Educación médica contínua en tocoginecología: su diseño curricular según niveles de complejidad en la atención perinatal

La evaluación particulariza en el componente estratégico "formación de recursos humanos aplicado al componente programático salud materno-infantil", de acuerdo con la estrategia global de la atención primaria de salud, referida a los niveles de complejidad en la atención perinatal