Cytochrome b5 reductase 3 overexpression and dietary nicotinamide riboside supplementation promote distinctive mitochondrial alterations in distal convoluted tubules of mouse kidneys during aging.

The kidney undergoes structural and physiological changes with age, predominantly studied in glomeruli and proximal tubules. However, limited knowledge is available about the impact of aging and anti-aging interventions on distal tubules. In this study, we investigated the effects of cytochrome b5 reductase 3 (CYB5R3) overexpression and/or dietary nicotinamide riboside (NR) supplementation on distal tubule mitochondria. Initially, transcriptomic data were analyzed to evaluate key genes related with distal tubules, CYB5R3, and NAD+ metabolism, showing significant differences between males and females in adult and old mice. Subsequently, our emphasis focused on assessing how these interventions, that have demonstrated the anti-aging potential, influenced structural parameters of distal tubule mitochondria, such as morphology and mass, as well as abundance, distance, and length of mitochondria-endoplasmic reticulum contact sites, employing an electron microscopy approach. Our findings indicate that both interventions have differential effects depending on the age and sex of the mice. Aging resulted in an increase in mitochondrial size and a decrease in mitochondrial abundance in males, while a reduction in abundance, size, and mitochondrial mass was observed in old females when compared with their adult counterparts. Combining both the interventions, CYB5R3 overexpression and dietary NR supplementation mitigated age-related changes; however, these effects were mainly accounted by NR in males and by transgenesis in females. In conclusion, the influence of CYB5R3 overexpression and dietary NR supplementation on distal tubule mitochondria depends on sex, genotype, and diet. This underscores the importance of incorporating these variables in subsequent studies to comprehensively address the multifaceted aspects of aging.

Prospective multicentre study of rectal carriage of multidrug-resistant Enterobacteriaceae among health-care workers in Spain.

OBJECTIVES: To investigate the rectal carriage of multidrug-resistant Enterobacteriaceae (colistin-resistant, extended-spectrum ß-lactamase (ESBL) -producers and/or carbapenemase-producers) among health-care workers (HCWs) from six Spanish hospitals. METHODS: Rectal swabs from 258 HCWs, employed in intensive care units, haematology wards and clinical microbiology laboratories from six hospitals in northern Spain were studied. They were cultured in selective media for Gram-negative resistant bacteria. Detection of antimicrobial resistance genes and multilocus sequence typing were performed by PCR and further sequencing. A questionnaire including data related to risk factors of colonization/infection by resistant bacteria (age, gender, chronic diseases, immunosuppressive therapies, invasive procedures or antimicrobial treatments) was given to each participant. RESULTS: No carbapenemase-producing Enterobacteriaceae were recovered. However, 8/258 HCWs (3.1%) were positive for ESBL-producing isolates. This rate was not higher than the colonization rate previously reported in Spain for healthy people in the community. Five isolates showed high-level resistance to colistin (MICs ranging from 8 to 128 mg/L) but all of them were negative for the mcr genes tested. No statistically significant risk factors for gut colonization by ESBL-producing or colistin-resistant Enterobacteriaceae were identified among the HCWs participating in the study. CONCLUSIONS: Our data suggest that working in hospitals does not represent a risk for rectal carriage of multidrug-resistant Enterobacteriaceae.

[Update in the pharmacological treatment of neuropathic pain]. / Actualización en el tratamiento farmacológico del dolor neuropático.

We provide an updated review of the pharmacological treatment of neuropathic pain, with emphasis on the latest evidence-based recommendations. Drugs proposed as first line include tricyclic antidepressants (particularly amitriptyline), serotonin-noradrenaline reuptake inhibitors (particularly duloxetine), pregabalin and gabapentin. Second-line treatments include 5% lidocaine medicated plasters and capsaicin 8% patches, only for peripheral neuropathic pain and tramadol; whereas potent opioids and botulinum toxin A (for peripheral neuropathic pain) are considered third-line treatments. Future perspectives include the development of new drugs and a more personalised therapeutic approach, which is made possible by recent progress in the assessment and understanding of neuropathic pain.

[Epidemiological surveillance for multidrug-resistant microorganisms in a general ICU]. / Vigilancia epidemiológica para microorganismos multirresistentes en una UCI polivalente.

OBJECTIVE: Multidrug resistant (MDR) microorganisms represent a threat for patients admitted in Intensive Care Units (ICUs). The objective of the present study is to analyse the results of epidemiological surveillance cultures for these microorganisms in one of these units. METHODS: General ICU. Retrospective analysis, descriptive statistics. Analysis of epidemiological surveillance cultures for MDR microorganisms in 2015. Studied microorganisms: Methicillin-resistant Staphylococcus aureus (MRSA), ESBL-and/or carbapenemase-producing Klebsiella pneumoniae (CESBL-KP) and MDR Acinetobacter baumannii (MDRAB). RESULTS: One thousand, two hundred and fifty nine patients admitted. A total of 2,234 specimens from 384 patients were analysed (690, 634, 62 and 286 were rectal, throat, nasal and skin swabs respectively). Global APACHE II was 18.3 ± 8 versus 21.7 ± 7.8 in patients colonized/infected on admission. Global mortality was 19.7% versus 22.3% in patients colonized/infected on admission. The higher sensitivities achieved with the different samples for the different microorganism detection were as follows. MRSA: 79% and 90% for nasal and nasal + throat swabs, respectively. MDRAB: 80% and 95% for throat and throat + rectal swabs, respectively. CESBL-KP: 95% and 98% for rectal and rectal + throat swabs, respectively. 94 out of the 384 patients (24.4%) were colonized/infected with MDR at admission. 134 patients (10.6% of the total patients admitted) were colonized/infected with a total of 169 MMR during the hospital stay. MRSA has the earliest colonization/infection (9.2 ± 6.4days) and ESBL-producing Enterobacteriaceae, the latest (18.7± 16.4 days). CONCLUSIONS: 24.4% of patients were colonized/infected by MDR at admission. Nasal, throat and rectal swabs were the most effective specimens for recovering MRSA, MDRAB and CESBL-KP, respectively. The combination of two specimens improves MDR detection except for CESBL-KP. Skin swabs are worthless. The most prevalent MDR at admission were ESBL-producing Enterobacteriaceae while the most frequent hospital acquired MDR was MDRAB..

Evaluation of a real-time PCR assay for rectal screening of OXA-48-producing Enterobacteriaceae in a general intensive care unit of an endemic hospital.

Carbapenemase-producing Enterobacteriaceae are increasing worldwide. Rectal screening for these bacteria can inform the management of infected and colonized patients, especially those admitted to intensive care units (ICUs). A laboratory developed, qualitative duplex real-time polymerase chain reaction assay for rapid detection of OXA-48-like and VIM producing Enterobacteriaceae, performed on rectal swabs, was designed and evaluated in an intensive care unit with endemic presence of OXA-48. During analytical assay validation, no cross-reactivity was observed and 100% sensitivity and specificity were obtained for both blaOXA-48-like and blaVIM in all spiked clinical samples. During the clinical part of the study, the global sensitivity and specificity of the real-time PCR assay for OXA-48 detection were 95.7% and 100% (P=0.1250), respectively, in comparison with culture; no VIM-producing Enterobacteriaceae were detected. Clinical features of patients in the ICU who were colonized or infected with OXA-48 producing Enterobacteriaceae, including outcome, were analyzed. Most had severe underlying conditions, and had risk factors for colonization with carbapenemase-producing Enterobacteriaceae before or during ICU admission, such as receiving previous antimicrobial therapy, prior healthcare exposure (including long-term care), chronic disease, immunosuppression and/or the presence of an intravascular catheter and/or mechanical ventilation device. The described real-time PCR assay is fast (~2-3hours, if DNA extraction is included), simple to perform and results are easy to interpret, features which make it applicable in the routine of clinical microbiology laboratories. Implementation in endemic hospitals could contribute to early detection of patients colonized by OXA-48 producing Enterobacteriaceae and prevention of their spread.

Neurofisiología de la empatía: una revisión de investigaciones / Neurophysiology of empathy: a review of investigations

La empatía es un constructo con múltiples definiciones y modelos explicativos, los cuales se han conformado a partir de observaciones e investigaciones en humanos y otros animales. En el presente, se revisaron estudios en humanos sanos, que vincula empatía con conducta motora, sistema nervioso autónomo y central. La evidencia presentada apoya la asociación entre empatía y el sistema de neuronas en espejo, la imitación facial, el contagio pupilar, el sistema autonómico, la interocepción, la conectividad neuronal, la ínsula, el cíngulo, entre otras. Finalmente, esta revisión incentiva el estudio, investigación y desarrollo de las múltiples áreas y disciplinas que tratan con la empatía.

Exome Sequencing and CNV Analysis on Chromosome 18 in Small Intestinal Neuroendocrine Tumors: Ruling Out a Suspect?

The genetic background in small intestinal neuroendocrine tumors is poorly understood, but several studies have revealed numerical imbalances. Loss of one copy of chromosome 18 is the most frequent genetic aberration in this tumor type, which indirectly suggests that a driver mutation may be present in the remaining allele. The aim of this study was to evaluate the mutation status on chromosome 18 in small intestinal neuroendocrine tumors. DNAs from 7 small intestinal neuroendocrine tumors were subjected to whole exome capture, followed by next generation sequencing and high resolution SNP array followed by copy number variation analysis. Exome capture sequencing generated an average coverage of 50.6-138.2. Only 19 genes were covered less than 8X. No tumor-specific somatic mutation was identified. Genomic profiling revealed loss of chromosome 18 in 5 out of 7 small intestinal neuroendocrine tumors and a number of other aberrancies. Loss of chromosome 18 is the most frequent genetic aberration in small intestinal neuroendocrine tumors, but no evidence for eventual mutations in the remaining allele. This suggests involvement of other mechanisms than point mutations in small intestinal neuroendocrine tumors tumorigenesis.

Extruded films of blended chitosan, low density polyethylene and ethylene acrylic acid.

The obtaining of chitosan extruded films was possible by using low density polyethylene (LDPE) as a matrix polymer and ethylene-acrylic acid copolymer as an adhesive, in order to ensure adhesion in the interphase of the immiscible polymers. The obtained blend films were resistant; however, a reduction in the mechanical resistance was observed as chitosan concentration increased. The thermal stability of the films showed a certain grade of interaction between polymers as seen in FTIR spectra. The antifungal activity of the extruded films was assessed against Aspergillus niger and high inhibition percentages were observed, which may be mainly attributed to barrier properties of the extruded films and the limited oxygen availability, resulting in the inability of the fungi to grow. A low adherence of fungal spores to the material surface was observed, mainly in areas with chitosan clumps, which can serve as starting points for material degradation.

Protocolo quirúrgico para el manejo de pacientes diabéticos sometidos a procedimientos de cirugía dental / Surgical protocol for the management of diabetic patients undergoing dental surgery procedures

El odontólogo general debe poseer conocimientos de manejo médico y farmacológico de pacientes diabéticos, y ser capaz de implementar en éstos un esquema terapéutico adecuado. El presente estudio trata sobre pacientes diabéticos sometidos a cirugía bucal, durante un año. El objetivo de esta investigación es crear un protocolo de cirugía bucal que logre una menor taza de complicaciones post-operatorias. Se recibieron 182 pacientes, promedio de edad de 60.8 años. La mayoría de los procedimientos fueron exodoncias (51,6%). Se encontró que los pacientes con glicemia superior a los 170mg/dl tiene 2,42 más posibilidades de desarrollar una complicación post quirúrgica (IC: 95%). Se registraron 5 complicaciones (sangramiento, alveolitis y flegmón) los cuales presentaban como promedio una glicemia de 182 mg/dl (DS: 7,583). Es fundamental lograr una mayor conciencia sobre la importancia del control de la glicemia en la población. Al ser la diabetes una patología en aumento es meritorio seguir incursionando en protocolos de atención que nos den un mejor control pre y post-operatorio

A general dentist must have knowledge of medical and pharmacological management of diabetic patients, and be able to organize an appropriate therapeutic treatment. The present study deals with diabetic patients undergoing oral surgery for a year. The aim of this research is to create a protocol of oral surgery that achieves smaller postoperative complications. There were 182 patients, average age of 60.8 years. Most of the procedures were extractions (51.6%). We found that patients with 170mg/dl higher blood glucose are to 2.42 more likely to develop post-surgical complication (CI: 95%). There were 5 complications (bleeding, dry socket and celulitis) which presented an average of 182 mg / dl of Blood Glucose (SD: 7.583). It is essential to enhance awareness about the importance of glycemic control in the population. As a condition of diabetes is increasing merit further inroads into treatment protocols to give us better pre and post-operative control

Cuerpo extraño de madera en ambas fosas ptérigomaxilares: caso clínico / Wooden foreign body in the two pterigomaxillary fossae: report of one case

We report a 72 years old male that received wooden fragments in the face, thrown by a wood grinding machine. At presentation, he had multiple facial and cervical wounds and a foreign body that passed from the left zygomatic region to the right retromaxilar region. A CAT sean showed that the foreign body crossed from the left zygomatic are to the pterigomaxillary fossa, crossing it and exiting from the mandibular notch. The patient was operated, a Lefort I osteotomy was performed and the foreign body removed. He was discharged seven days later with left frontal and right orbital pareses.

Los cuerpos extraños (CE) son frecuentes como secuela de trauma en la región de cabeza y cuello, variando considerablemente en cuanto a composición, localización y tamaño. Hay pocos reportes de CE que penetren en la fosa ptérigomaxilar, siendo más común encontrarlos en relación al área orbitaria. Este reporte describe un caso de CE de madera, transfixiante, involucrado en ambas fosas ptérigomaxilares en un paciente masculino de 72 años, y las técnicas quirúrgicas y complementarias usadas para su remoción.

Exergy optimization in a steady moving bed heat exchanger.

This work provides an energy and exergy optimization analysis of a moving bed heat exchanger (MBHE). The exchanger is studied as a cross-flow heat exchanger where one of the phases is a moving granular medium. The optimal MBHE dimensions and the optimal particle diameter are obtained for a range of incoming fluid flow rates. The analyses are carried out over operation data of the exchanger obtained in two ways: a numerical simulation of the steady-state problem and an analytical solution of the simplified equations, neglecting the conduction terms. The numerical simulation considers, for the solid, the convection heat transfer to the fluid and the diffusion term in both directions, and for the fluid only the convection heat transfer to the solid. The results are compared with a well-known analytical solution (neglecting conduction effects) for the temperature distribution in the exchanger. Next, the analytical solution is used to derive an expression for the exergy destruction. The optimal length of the MBHE depends mainly on the flow rate and does not depend on particle diameter unless they become very small (thus increasing sharply the pressure drop). The exergy optimal length is always smaller than the thermal one, although the difference is itself small.

Molecular identification of two genotypes of mumps virus causing two regional outbreaks in Asturias, Spain.

BACKGROUND: In spite of universal vaccination, several sporadic cases of mumps infection, which could produce outbreaks, are detected every year in different countries. OBJECTIVE: Mumps virus strains causing two regional outbreaks in Asturias (Spain) were phylogenetically characterized. STUDY DESIGN: Mumps virus strains, which were detected in samples from patients belonging to two regional outbreaks in Asturias, were characterized by sequencing of the SH gene and further alignment to homologous sequences of representative strains of the different mumps genotypes. RESULTS: Two different strains (Ast/SP02 and Ast/SP07) were isolated. Sequence analysis revealed that while Ast/SP02 belonged to genotype H, Ast/SP07 was phylogenetically close to UK02-19, a reference strain for a new genotype. Both strains belonged to different genotypes from those used in the vaccination (Jeryl-Lynn strain is genotype A). CONCLUSION: Mumps virus strains different from those used in vaccination program can cause mumps outbreaks even in vaccinated patients.

Release of butylated hydroxytoluene from an active film packaging to Asadero cheese and its effect on oxidation and odor stability.

Antioxidant active packaging consisting of coextruded films made of low density polyethylene (LDPE) added with 0, 8, and 14 mg/g of butylated hydroxytoluene (BHT) and polyamide 6/66 were fabricated. The release of BHT from the films to Asadero cheese was determined. Most of the BHT was diffused from the LDPE layer to the cheese during the first 20 d of storage at 5 degrees C. Diffusion coefficient for the diffusion of BHT from the films 8 and 14 to the cheese was calculated as 6.24E-12 and 6.26E-12 cm2/s, respectively. The release of BHT from the film added with 8 mg/g of the antioxidant in the LDPE layer complied with the legal limit established for food products. However, the film added with 14 mg/g of the antioxidant exceeded that limit. The film added with 8 mg/g of BHT maintained the same levels of oxidized odor from 20 to 100 d of storage.

Utilidad de la osteocalcina y los N-telopeptidos para la evaluacion del recambio oseo en mujeres postmenopausicas con y sin terapia de reemplazo hormonal / Evaluation of bone remodeling comparing Osteocalcin and N-telopeptides levels in pre and postmenopausal women with or without HRT

Introducción: Los marcadores bioquímicos son una técnica diagnóstica, para evaluar la remodelación ósea. Actualmente, se han desarrollado marcadores más específicos de formación ósea (osteocalcina) y de reabsorción (N-telopéptidos). Objetivos: Comparar los niveles de osteocalcina y N-telopéptidos en mujeres premenopáusicas y postmenopáusicas, con y sin terapia de reemplazo hormonal (TRH). Materiales y métodos: Se estudiaron 76 mujeres sanas quienes no estuvieran recibiendo ningún medicamento que afectara el recambio óseo, distribuidas en tres grupos: A) 32 mujeres con más de un año de menopausia y sin TRH, B) 24 mujeres ostmenopáusicas, con más de tres meses de TRH y C) 20 controles en edad fértil y con ciclos regulares. La osteocalcina en sangre (Novocalcin©) y los N-telopéptidos en orina (Osteomark©) se midieron por el método Elisa. Resultados: Las mujeres postmenopáusicas fueron comparables por edad, paridad, tiempo de menopausia e índice de masa corporal. Hubo diferencias entre las postmenopáusicas con TRH y sin TRH para los N-telopéptidos, 44.9 ñ 24.4 nm ECO/mm y 78.1 ñ 34.4 nm ECO/mm, respectivamente (p<0.001). Igualmente, para la osteocalcina 2 ñ 2.8 ng /mi con TRH y 4.7 ñ 3.2 ng/ml sin TRH (p<0.001). Los niveles de N-telopéptidos en el grupo control fueron de 58.2 ñ21.3 nm ECO/mm, los cuales no difieren del grupo con TRH (p<0.l6), pero sí del grupo sin TRH (p<0.026). Los niveles de osteocalcina en el grupo control fueron de 3.3 ñ 2.9 ng / mi, los cuales no difieren significativamente de los otros dos grupos

Tropical spastic paraparesis.

Human T-cell lymphotropic virus type I (HTLV-I) is the cause of endemic tropical spastic paraparesis (TSP) or HTLV-I-associated myelopathy (HAM). Because TSP/HAM is not a fatal disease, the neuropathology of this disease, albeit relatively well understood, is based on the examination of just a few incidental cases. We summarise our experience with the neuropathology of tropical spastic paraparesis/HTLV-I associated myelopathy (TSP/HAM). We studied three cases of TSP/HAM from different parts of the world. We demonstrated peculiar lamellated structures, called "multilamellar bodies" (MLB). It is tempting to suggest that MLB may represent specific ultrastructural markers of TSP/HAM. The pathology of the anteriorand posterior horns was similar and comprised axonal degeneration, accompanied by extensive astrocytic gliosis. Lymphocytic infiltration, particularly observed as "cuffs" around blood vessels, was scattered among other cellular elements. Ultrastructurally, myelin sheaths were relatively well preserved, and some demyelinated but not remyelinated fibres were observed. Moreover, axons with abnormal accumulations of neurofilaments, suggestive of axonal degeneration, were detected. Several axons contained Hirano bodies. In many samples glial processes replaced most of the remaining neuropil.

Ultrastructural pathology of a Chilean case of tropical spastic paraparesis/human T-cell lymphotropic type I-associated myelopathy (TSP/HAM).

Human T-cell lymphotropic virus type I (HTLV-I), is the cause of endemic tropical spastic paraparesis (TSP) or HTLV-I-associated myelopathy (HAM). Because TSP/HAM is not a fatal disease, the neuropathology of this disease, albeit relatively well understood, is based on the examination of just a few incidental cases. Previously, we demonstrated peculiar lamellated structures, called "multilamellar bodies" (MLB). In this report, we present the ultrastructural neuropathology of a TSP/HAM case from Chile, with further detailed descriptions of MLB. It is tempting to suggest that MLB may represent specific ultrastructural markers of TSP/HAM. The pathology of the anterior and posterior horns was similar and was comprised of axonal degeneration, accompanied by extensive astrocytic gliosis. Lymphocytic infiltration, particularly observed as "cuffs" around blood vessels, was scattered among other cellular elements. Ultrastructurally, myelin sheaths were relatively well preserved, and some demyelinated but not remyelinated fibers were observed. Moreover, axons with abnormal accumulations of neurofilaments, suggestive of axonal degeneration, were detected. Several axons contained Hirano bodies. In many samples, glial processes replaced most of the remaining neuropil. In a few specimens of the anterior and posterior horns of the spinal cord, MLB were observed. These structures consisted of stacks of 30 to 40 electron-dense lamellae, which were interrupted by narrow electron-lucent spaces. All of the lamellae were immersed within an amorphous substance of intermediate density. Neurons of the dorsal root ganglia were basically normal except for increased lipofuscin accumulation. As in the spinal cord, myelinated axons were well preserved, but a few were demyelinated and surrounded by concentric arrays of Schwann cell membranes. Also, axons of the dorsal roots accumulated increased number of neurofilaments. Mast cells and Schwann cells were increased in number, the latter containing abundant pi granules and myelin fragments.