Conduct and reporting of multivariate network meta-analyses: a scoping review.

OBJECTIVES: Combining multivariate and network meta-analysis methods simultaneously in a multivariate network meta-analysis (MVNMA) provides the methodological framework to analyze the largest amount of evidence relevant to decision-makers (i.e., from indirect evidence and correlated outcomes). The objectives of this scoping review were to summarize the characteristics of MVNMAs published in the health sciences literature and map the methodological guidance available for MVNMA. STUDY DESIGN AND SETTING: We searched MEDLINE, Embase, and the Cumulative Index to Nursing and Allied Health Literature from inception to 28 August 2023, along with citations of included studies, for quantitative evidence syntheses that applied MVNMA and articles addressing MVNMA methods. Pairs of reviewers independently screened potentially eligible studies. Collected data included bibliographic, methodological, and analytical characteristics of included studies. We reported results as total numbers, frequencies, and percentages for categorical variables and medians and interquartile ranges for continuous variables that were not normally distributed. RESULTS: After screening 1,075 titles and abstracts, and 112 full texts, we included 38 unique studies, of which, 10 were quantitative evidence syntheses that applied MVNMA and 28 were articles addressing MVNMA methods. Among the 10 MVNMAs, the first was published in 2013, four used studies identified from already published systematic reviews, and eight addressed pharmacological interventions, which were the most common interventions. They evaluated interventions for metastatic melanoma, colorectal cancer, prostate cancer, oral hygiene, disruptive behavior disorders, rheumatoid arthritis, narcolepsy, type 2 diabetes, and overactive bladder syndrome. Five MVNMAs analyzed two outcomes simultaneously, and four MVNMAs analyzed three outcomes simultaneously. Among the articles addressing MVNMA methods, the first was published in 2007 and the majority provided methodological frameworks for conducting MVNMAs (26/28, 93%). One study proposed criteria to standardize reporting of MVNMAs and two proposed items relevant to the quality assessment of MVNMAs. Study authors used data from 18 different illnesses to provide illustrative examples within their methodological guidance. CONCLUSIONS: The application of MVNMA in the health sciences literature is uncommon. Many methodological frameworks are published; however, standardization and specific criteria to guide reporting and quality assessment are lacking. This overview of the current landscape may help inform future conduct of MVNMAs and research on MVNMA methods.

Mycobacterium tuberculosis ß-lactamase variant reduces sensitivity to ampicillin/avibactam in a zebrafish-Mycobacterium marinum model of tuberculosis.

The ß-lactamase of Mycobacterium tuberculosis, BlaC, hydrolyzes ß-lactam antibiotics, hindering the use of these antibiotics for the treatment of tuberculosis. Inhibitors, such as avibactam, can reversibly inhibit the enzyme, allowing for the development of combination therapies using both antibiotic and inhibitor. However, laboratory evolution studies using Escherichia coli resulted in the discovery of single amino acid variants of BlaC that reduce the sensitivity for inhibitors or show higher catalytic efficiency against antibiotics. Here, we tested these BlaC variants under more physiological conditions using the M. marinum infection model of zebrafish, which recapitulates hallmark features of tuberculosis, including the intracellular persistence of mycobacteria in macrophages and the induction of granuloma formation. To this end, the M. tuberculosis blaC gene was integrated into the chromosome of a blaC frameshift mutant of M. marinum. Subsequently, the resulting strains were used to infect zebrafish embryos in order to test the combinatorial effect of ampicillin and avibactam. The results show that embryos infected with an M. marinum strain producing BlaC show lower infection levels after treatment than untreated embryos. Additionally, BlaC K234R showed higher infection levels after treatment than those infected with bacteria producing the wild-type enzyme, demonstrating that the zebrafish host is less sensitive to the combinatorial therapy of ß-lactam antibiotic and inhibitor. These findings are of interest for future development of combination therapies to treat tuberculosis.

Curación de úlcera venosa crónica de la pierna con aloinjerto de membrana amniocoriónica humana fresca / Healing of a chronic ulcer of the lower limb of venous origin with fresh human amniochorionic membrane allograft

En su estado fresco, la membrana amniocoriónica contiene varias células multipotenciales, factores de crecimiento y proteínas de la matriz extracelular que contribuyen a la cicatrización de las úlceras vasculares crónicas. Para demostrar su efectividad, se recurrió a un aloinjerto de membrana placentaria humana fresca para tratar una úlcera venosa crónica, de 12 x 10 cm y con 40 años de evolución, en el zona maleolar interna e izquierda de una paciente de 89 años de edad. Transcurridos 60 días del injerto, la úlcera se encontraba cicatrizada en el 100 % de su superficie, observándose una cicatriz rosada clara en cuyos bordes se apreciaron intentos de pigmentación. El aloinjerto de membrana amniocoriónica humana fresca es una alternativa terapéutica para la curación de úlceras vasculares crónicas persistentes en las extremidades inferiores.

In its fresh state, the amniochorionic membrane contains various multipotential cells, growth factors, and extracellular matrix proteins that contribute to the healing of chronic vascular ulcers. To demonstrate its effectiveness, a fresh human placental membrane allograft was applied to a chronic venous ulcer in the lower limb of an 89-year-old female patient with a 12 x 10 cm ulcerated lesion of 40 years of evolution in the malleolar area of her left lower limb. Sixty days after the graft, the ulcer was healed in 100% of its surface and a light pink scar on the edges indicated possible pigmentation. Fresh human amniochorionic membrane allograft is a therapeutic alternative for the healing of refractory chronic vascular ulcers of the lower extremities.

Cladodes: Chemical and structural properties, biological activity, and polyphenols profile.

The nopal cactus is an essential part of the Mexican diet and culture. The per capita consumption of young cladodes averages annually to 6.4 kg across the nation. In addition to contributing to the country's food culture, the nopal is considered a food with functional characteristics since, in addition to providing fiber, an important group of polyphenolic compounds is present, which has given cladodes to be considered a healthy food, for what they have been incorporated into the diet of Mexican people and many other countries worldwide. Research suggests that polyphenols from cladodes act as antioxidants and antidiabetics. This review studies the main phenolic components in cladodes and summarizes both conventional and novel methods to identify them.

Bean phenolic compound changes during processing: Chemical interactions and identification.

The common bean (Phaseolus vulgaris L.) represents one of the main crops for human consumption, due to its nutritional and functional qualities. Phenolic compounds have beneficial health effects, and beans are an essential source of these molecules, being found mainly in the seed coat and its color depends on the concentration and type of phenolic compounds present. The bean during storage and processing, such as cooking, germination, extrusion, and fermentation, undergoes physical, chemical, and structural changes that affect the bioavailability of its nutrients; these changes are related to the interactions between phenolic compounds and other components of the food matrix. This review provides information about the identification and quantification of phenolic compounds present in beans and the changes they undergo during processing. It also includes information on the interactions between the phenolic compounds and the components of the bean's cell wall and the analytical methods used to identify the interactions of phenolic compounds with macromolecules.

Characterization of a pluripotent stem cell-derived matrix with powerful osteoregenerative capabilities.

Approximately 10% of fractures will not heal without intervention. Current treatments can be marginally effective, costly, and some have adverse effects. A safe and manufacturable mimic of anabolic bone is the primary goal of bone engineering, but achieving this is challenging. Mesenchymal stem cells (MSCs), are excellent candidates for engineering bone, but lack reproducibility due to donor source and culture methodology. The need for a bioactive attachment substrate also hinders progress. Herein, we describe a highly osteogenic MSC line generated from induced pluripotent stem cells that generates high yields of an osteogenic cell-matrix (ihOCM) in vitro. In mice, the intrinsic osteogenic activity of ihOCM surpasses bone morphogenic protein 2 (BMP2) driving healing of calvarial defects in 4 weeks by a mechanism mediated in part by collagen VI and XII. We propose that ihOCM may represent an effective replacement for autograft and BMP products used commonly in bone tissue engineering.

REGISTROS DE Dryophthorinae (Coleóptera: Curculionidae) DE LA COSTA CARIBE COLOMBIANA / Records of Dryophthorinae (Coleoptera: Curculionidae) on Colombian Caribbean Coast

RESUMEN Dyophthorinae es una subfamilia con varias especies asociadas principalmente al consumo de monocotiledóneas, siendo consideradas en Colombia plaga en cultivos de palmas, musáceas y granos como maíz, trigo, sorgo y arroz. En este documento se presenta un listado de las especies de Dryophthorinae para los departamentos de la costa Caribe colombiana, construido a partir de las visitas a colecciones entomológicas y de la revisión de literatura. Para la región se registraron 11 especies: Cosmopolites sordidus, Dynamis borassi, Mesocordylus striatus, Metamasius hemipterus, M. hebetatus, Polytus mellerborgii, Rhynchophorus palmarum, Rhodobaenus sp., Rhinostomus barbirostris, Sitophilus zeamais y S. oryzae, algunas de las cuales se documentan por primera vez para esta zona. Se discute la importancia de realizar muestreos sistemáticos de este grupo y estudios tendientes a mejorar el conocimiento sobre su distribución y biología, así como su impacto en producciones agrícolas y su potencial como plagas en el país.

ABSTRACT Dryophthorinae is a relatively small weevil subfamily associated mainly with monocots. There are species in Colombia considered pests in the palm and Musaceae crops. In this document, a list of the species of Dryophthoridae for the departments of the Colombian Caribbean coast is presented, based on data from entomological collections and literature review. For the region, 11 species were recorded: Cosmopolites sordidus, Dynamis borassi, Mesocordylus striatus, Metamasius hemipterus, M. hebetatus, Polytus mellerborgii, Rhynchophorus palmarum, Rhodobaenus sp., Rhinostomus barbirostris, Sitophilus zeamais and S. oryzae, some of which are registered for the first time for the area. The importance of systematically sampling this group, and studies leading to improve knowledge about their distribution and biology, as well as its impact on agricultural production and their potential as pests in the country, are discussed.

Home visits of the nurse and its relationship with hospitalization by diseases sensitive to primary health care / Visitas domiciliares del enfermero y su relación con las hospitalizaciones por enfermedades sensibles a la atención primária / Visitas domiciliares do enfermeiro e sua relação com as internações por doenças sensíveis à atenção básica

Abstract Objective: To identify if nurses' home visits recorded by the family health strategy are proportional to the registered population and the population covered by the family health team, and its relationship with the rate of hospitalization for conditions sensitive to primary health care. Method: Secondary data were gathered from the Information Systems of Primary Care and Hospitalization regarding potential population coverage, number of visits done, hospitalizations for diseases sensitive to primary health care. An exploratory analysis was performed with data grouping for triennium (2010-2012 and 2013-2015) and assignment of scores for each variable, creating the classification strata in: low, medium and high. Results: It was identified that the number of registered home visits does not meet the estimated population coverage as well as does not impact on the admissions sensitive to primary health care. Conclusion and implications for practice: Even with high coverage of the family health strategy, home visits are not the main focus of nurses yet. Home visits should be used as a tool for disease prevention and health promotion, which may explain the non-reduction of hospitalizations sensitive to primary health care.

Resumen Objetivo: Identificar si las visitas domiciliarias registradas en la Estrategia Salud de la Familia son proporcionales a la población registrada y la población cubierta por la estrategia, y su relación con la tasa de internación por condiciones sensibles a la atención básica. Método: Se recogieron datos secundarios del Sistema de Información de la Atención Básica y Sistemas de Información Hospitalaria con respecto a: cobertura poblacional potencial, número de visitas realizadas, internaciones por enfermedades sensibles a la atención básica. Se ha llevado a cabo un análisis exploratorio con agrupación de los datos por trienio (2010-12 y 2013-15) y asignación de escores para cada variable, permitiendo establecer la clasificación en baja, media y alta. Resultados: Se identificó que la cantidad de visitas domiciliarias registradas no atiende la cobertura poblacional estimada así como no impacta en las internaciones sensibles a la atención básica. Conclusión e implicaciones para la práctica: A pesar de la elevada cobertura de la estrategia salud de la familia, las visitas domiciliarias aún no son el principal foco de los enfermeros. Las visitas domiciliarias deberían ser utilizadas como herramienta de prevención de enfermedades y promoción de la salud, lo que quizá explique la no reducción de las internaciones sensibles a la atención básica.

Resumo Objetivo: Identificar se as visitas domiciliares registradas pela estratégia saúde da família são proporcionais à população registrada e à população coberta pela estratégia, e sua relação com a taxa de internação por condições sensíveis a atenção básica. Método: Foram coletados dados secundários do Sistema de Informação da Atenção Básica e Sistema de Informações Hospitalares referentes a: cobertura populacional potencial, número de visitas realizadas, internações por doenças sensíveis a atenção básica. Foi realizada análise exploratória com agrupamento dos dados por triênio (2010-2012 e 2013-2015) e atribuição de escores para cada variável, permitindo estabelecer a classificação a baixa, média e alta. Resultados: Identificou-se que a quantidade de visitas domiciliares registradas não atende a cobertura populacional estimada, assim como não impacta nas internações sensíveis à atenção básica. Conclusão e implicações para a prática: Mesmo com elevada cobertura da estratégia saúde da família, as visitas domiciliares ainda não são o principal foco dos enfermeiros. As visitas domiciliares deveriam ser utilizadas como ferramenta de prevenção de doenças e promoção da saúde, o que talvez explique a não redução das internações sensíveis à atenção básica.

Isolation and Analysis of Mesenchymal Progenitors of the Adult Hematopoietic Niche.

Mesenchymal stromal cells are an important component of the adult hematopoietic stem cell niche. They are a diverse population of cells that include a hierarchy of primitive, intermediate, and mature osteoprogenitors that support HSCs and supply the bone with matrix producing osteoblast. To understand the different roles played by individual types of progenitors, it is necessary to separate individual populations and analyze them in a controlled environment. Here we describe two transplantation models, an ectopic bone forming assay and an intravenous injection assay, in which niche components can be isolated and manipulated to dissect their individual properties.

Conventional influenza vaccines influence the performance of a universal influenza vaccine in mice.

Universal influenza vaccines are designed to protect against diverse strains of influenza virus. Preclinical testing of new vaccine candidates is usually done in naïve animals, despite intended use in the human population with its varied immune history including responses to previous vaccinations. As an approach more relevant to human use, we tested a candidate universal influenza vaccine in mice with a history of conventional vaccination. Female BALB/c mice were given two intramuscular doses of inactivated influenza vaccine (IIV) or diphtheria and tetanus toxoids vaccine (DT), one month apart. Another group was given two intranasal doses of live attenuated influenza virus (LAIV). One month after the second dose, mice were given the universal influenza vaccine: recombinant adenoviruses expressing influenza A nucleoprotein (A/NP) and matrix 2 (M2) (A/NP + M2-rAd). Immune responses to universal vaccine antigens A/NP and M2 were assessed by ELISA and interferon-γ ELISPOT. Protection was tested by challenge with mouse-adapted A/FM/1/47 (H1N1) and monitoring for weight loss and survival. Universal vaccine performance was enhanced, inhibited or unaffected by particular prior vaccinations. Mice given Afluria IIV and LAIV had greater antibody and T-cell response to A/NP than mice without prior vaccination, providing examples of enhanced A/NP + M2-rAd performance. Though Fluvirin IIV partially inhibited, the universal vaccine still provided considerable protection unlike conventional vaccination. Fluzone IIV and DT had no effect on A/NP + M2-rAd performance. Thus our results demonstrate that universal vaccine candidate A/NP + M2-rAd was at least partially effective in mice with diverse prior histories. However, the degree of protection and nature of the immune responses may be affected by a history of conventional vaccination and suggests that performance in humans would be influenced by immune history.

Adolescents' decision to pursue bariatric surgery: a systematic review protocol.

REVIEW QUESTION/OBJECTIVE: The objective of this qualitative review is to identify what motivates an adolescent to pursue bariatric surgery.

Características clínicas y bioeléctricas determinadas por bioimpedancia en pacientes con enfermedad pulmonar obstructiva crónica / Clinical and bioelectric characteristics determined by bioimpedance in patients with chronic obstructive pulmonary disease

Se realizó un estudio descriptivo y transversal de 99 pacientes con enfermedad pulmonar obstructiva crónica, atendidos en consulta de Neumología del Hospital General Docente Dr Juan Bruno Zayas Alfonso de Santiago de Cuba, del 1 al 15 de febrero de 2015, con vistas a determinar algunos compartimientos de la composición corporal, según el modelo de organización bicompartimental del cuerpo humano y el método de la bioimpedancia eléctrica. En la serie predominaron el sexo masculino y las edades de 50 a 69 años de edad, y los grados III y II, en ese orden de frecuencia, fueron los más representativos de la enfermedad. Por su parte, la desnutrición y la disfunción muscular resultaron 2 factores determinantes de la gravedad clínica y el pronóstico de la afección. De los parámetros bioeléctricos analizados, se ratificó la masa muscular esquelética como el de supervivencia y de morbilidad y mortalidad; asimismo se demostró el ángulo de fase como parámetro de la bioimpedancia, mayormente establecido para el diagnóstico y el pronóstico clínicos

A descriptive and cross-sectional study of 99 patients with chronic obstructive pulmonary disease was carried out. They were assisted in the Pneumology Service Dr Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba, from February 1st to 15th, 2015 aimed at determining some compartments of body composition, according to the pattern of bicompartment organization of the human body and the method of the electric bioimpedance. In the series there was a prevalence of the male sex aged 50 to 69, and a higher frequency of III and II degrees (in that order) of the disease. On the other hand, malnutrition and muscular dysfunction were the 2 determining factors of clinical severity and prognosis of the disorder. Of the bioelectric parameters analyzed, the skeletal muscular mass was ratified as that of survival, morbidity and mortality; also the phase angle was demonstrated as bioimpedance parameter, mostly established for the clinical diagnosis and prognosis

Identification of a CD133-CD55- population functions as a fetal common skeletal progenitor.

In this study, we identified a CD105+CD90.1-CD133-CD55- (CD133-CD55-) population in the fetal skeletal element that can generate bone and bone marrow. Besides osteoblasts and chondrocytes, the CD133-CD55- common progenitors can give rise to marrow reticular stromal cells and perivascular mesenchymal progenitors suggesting they function as the fetal common skeletal progenitor. Suppression of CXCL12 and Kitl expression in CD133-CD55- common progenitors severely disrupted the BM niche formation but not bone generation. Thus, CD133-CD55- common progenitors are the main source of CXCL12 and Kitl producing cells in the developing marrow.

Identification of a common mesenchymal stromal progenitor for the adult haematopoietic niche.

Microenvironment cues received by haematopoietic stem cells (HSC) are important in regulating the choice between self-renewal and differentiation. On the basis of the differential expression of cell-surface markers, here we identify a mesenchymal stromal progenitor hierarchy, where CD45-Ter119-CD31-CD166-CD146-Sca1+(Sca1+) progenitors give rise to CD45-Ter119-CD31-CD166-CD146+(CD146+) intermediate and CD45-Ter119-CD31-CD166+CD146-(CD166+) mature osteo-progenitors. All three progenitors preserve HSC long-term multi-lineage reconstitution capability in vitro; however, their in vivo fates are different. Post-transplantation, CD146+ and CD166+ progenitors form bone only. While Sca1+ progenitors produce CD146+, CD166+ progenitors, osteocytes and CXCL12-producing stromal cells. Only Sca1+ progenitors are capable of homing back to the marrow post-intravenous infusion. Ablation of Sca1+ progenitors results in a decrease of all three progenitor populations as well as haematopoietic stem/progenitor cells. Moreover, suppressing production of KIT-ligand in Sca1+ progenitors inhibits their ability to support HSCs. Our results indicate that Sca1+ progenitors, through the generation of both osteogenic and stromal cells, provide a supportive environment for hematopoiesis.

Aspectos clinicoepidemiológicos en pacientes con coinfección por sida y tuberculosis en la provincia de Santiago de Cuba / Clinical and epidemiological aspects in patients with coinfection due to aids and tuberculosis in Santiago de Cuba province

Se efectuó un estudio descriptivo y retrospectivo de los 15 pacientes con coinfección por sida y tuberculosis en la provincia de Santiago de Cuba, en el período de enero del 2004 a diciembre del 2013, a fin de caracterizarles según algunas variables clinicoepidemiológicas: edad, sexo, comportamiento sexual, formas clínicas y radiológicas de la tuberculosis, conteo de CD4, pruebas microbiológicas del esputo, pruebas inmunológicas y evolución. En la serie resultó superior el total de hombres bisexuales y homosexuales, el diagnóstico de tuberculosis después de 6 meses de completar la quimioprofilaxis, con mayor incidencia de la forma pulmonar de la enfermedad, los rayos X con infiltrado en bases, el conteo de CD4 por debajo de 200 células/mm³, el esputo directo y cultivo negativos, además de la prueba de Mantoux no reactiva. La mayoría de los afectados evolucionó favorablemente y se les dio el alta médica al finalizar el tratamiento y ser curados de tuberculosis.

A descriptive and retrospective study of the 15 patients with coinfection due to AIDS and tuberculosis in Santiago de Cuba province was carried out in the period of January, 2004 to December, 2013, in order to characterize them according to some clinical-epidemiological variables: age, sex, sexual behavior, clinical and radiological features of tuberculosis, CD4 count, sputum microbiological tests, immunological tests and clinical course. In the series the total of bisexual and homosexual men, the tuberculosis diagnosis after 6 months of completing the chemoprophylaxis, with higher incidence in the pulmonary type of the disease, the X rays with base infiltrates, the CD4 count under 200 cells/mm³, the direct sputum and negative culture, besides the non-reactive Mantoux test. Most of the affected patients had a favorable clinical course and they were discharged when concluding the treatment and were cured of tuberculosis.

Age Dependence of Immunity Induced by a Candidate Universal Influenza Vaccine in Mice.

Influenza has a major impact on the elderly due to increased susceptibility to infection with age and poor response to current vaccines. We have studied universal influenza vaccine candidates based on influenza A nucleoprotein and matrix 2 (A/NP+M2). Long-lasting protection against influenza virus strains of divergent subtypes is induced, especially with mucosal immunization. Here, we tested universal vaccination in BALB/c mice of different ages. Vaccination used intramuscular DNA priming to A/NP+M2 followed by intranasal (i.n.) boosting with recombinant adenoviruses (rAd) expressing the same antigens, or only A/NP+M2-rAd given i.n. Antigen-specific systemic antibody responses were induced in young, middle-aged, and elderly mice (2, 11-17, and 20 months old, respectively), but decreased with age. Antibody responses in bronchoalveolar lavage (BAL) were detected only in young mice. Antigen-specific T cell responses were seen in young and middle-aged but not elderly mice. A/NP+M2 vaccination by the two regimens above protected against stringent challenge in young and middle-aged mice, but not in elderly mice. However, mice vaccinated with A/NP-rAd or A/M2-rAd during their youth were partially protected against challenge 16 months later when they were elderly. In addition, a regimen of two doses of A/NP+M2-rAd given i.n. one month apart beginning in old age protected elderly mice against stringent challenge. This study highlights the potential benefit of cross-protective vaccines through middle age, and suggests that their performance might be enhanced in elderly individuals who had been exposed to influenza antigens early in life, as most humans have been, or by a two-dose rAd regimen given later in life.

Exosome-mediated microenvironment dysregulation in leukemia.

The hematopoietic stem cell (HSC) niche is composed of a complex set of stromal support cells that maintain HSCs and promote normal hematopoiesis. We now know that molecular changes within the hematopoietic niche contribute to leukemia development. Leukemia cells often reorganize the hematopoietic niche to promote and support their own survival and growth. Here we will summarize recent works that decipher the normal hematopoietic niche cellular components and describe how the leukemia-transformed niche contributes to hematological malignances. Finally, we will discuss recent publications that highlight a possible role for exosomes in the leukemia-induced niche reorganization. This article is part of a Special Issue entitled: Tumor Microenvironment Regulation of Cancer Cell Survival, Metastasis, Inflammation, and Immune Surveillance edited by Peter Ruvolo and Gregg L. Semenza.

Conocimientos sobre la enfermedad renal crónica y el proceder de hemodiálisis / Knowledge about chronic kidney disease and hemodialysis procedure

Introducción: el consentimiento informado supone un proceso que va más allá de la firma de un documento de autorización. Objetivo: determinar el nivel de conocimientos sobre la enfermedad renal crónica y el proceder de hemodiálisis de los pacientes del Hospital General Docente Abel Santamaría Cuadrado de Pinar del Río en el período comprendido de marzo a mayo de 2012. Material y método: se realizó un estudio observacional, descriptivo, transversal y aplicado. El universo estuvo constituido por los pacientes que reciben hemodiálisis (N = 102). La muestra estuvo integrada por los pacientes que recibieron hemodiálisis el día escogido para aplicar la encuesta que debió coincidir con la segunda sesión de hemodiálisis de la semana, utilizando un método aleatorio simple (n= 85), a los que se aplicó una encuesta formulario. Para determinar la asociación entre variables se utilizó el estadígrafo ji cuadrado al 95 % de confianza. Resultados: la muestra resultó ser mayoritariamente joven, con bajo nivel educacional, siendo el dominio de la enfermedad bastante bajo, y aún más crítico el conocimiento sobre posibles complicaciones durante la hemodiálisis, cuestiones evitables de existir un documento informador previo a este proceder. Conclusiones: los pacientes con enfermedad renal crónica y con tratamientos depuradores, como la hemodiálisis, necesitan la existencia de un consentimiento informado, que sea adaptable a cada paciente, para prepararlos mejor y así lograr bienestar, confort y su total cooperación.

Introduction: informed knowledge involves a process that goes beyond the signing of an authorization document. Objective: to determine the level of knowledge about the chronic kidney disease and the hemodialysis procedure by the patients of Abel Santamaría Cuadrado General Teaching Hospital of Pinar del Río, in the period between March and May 2012. Material and method: an observational, descriptive, cross-sectional and applied study was performed. The universe was made up of the patients undergoing hemodialysis (n=120). The sample was composed by the patients who underwent hemodialysis on the days chosen for applying the survey, which should coincide with the second session of hemodialysis within the week, using the random simple method (n=85), whom were conducted the questionnaire-survey on. To determine association amongst variables, the statistical chi-square test was used at 95% of confidence. Results: the sample came to be mostly young, with low schooling, being also low their knowledge on the disease, and even more critical their knowledge about potential complications in hemodialysis, matters evitable to occur in an authorization document before this procedure. Conclusions: patients with chronic kidney disease and with purifying treatments, as hemodialysis, need to know about a proper informed concernment, applicable to each patient, in order to better prepare them and in doing so to achieve welfare, comfort and their total recovery.

Functional characterization of the putative hepatitis B virus core protein late domain using retrovirus chimeras.

The hepatitis B virus (HBV) Core protein encodes a late (L)-domain like motif (129PPAYRPPNAP(138)) that has been purported to serve as a docking site for recruitment of host factors such as Nedd4 that can mediate viral particle release from infected cells. However, mutation of this region of Core typically disrupts nucleocapsid formation in the cytoplasm, making it difficult to ascertain if the Core PPAY motif constitutes a functional L-domain that mediates HBV release in the context of replicating virus. Since many viral L-domains are functionally interchangeable between different virus families, and such swapping experiments have been used as a tool to identify other viral sequences with L-domain activity, we generated chimeric constructs between murine leukemia virus (MLV) Gag and HBV Core to determine if the potential HBV L-domain motif is sufficient to stimulate virus release. We found that the HBV Core PPAY motif, but not the PNAP motif, demonstrates L-domain activity in the context of MLV replication to direct virus release and infectious virion production. Additionally, we found that overexpression of the cellular Nedd4 or WWP1 ubiquitin ligases stimulates release of a partially defective PPAY domain mutant, providing further evidence supporting a role for the Nedd4 ubiquitin ligase in promoting HBV release. These studies lend further insight into the mechanisms used by HBV to mediate its release from infected cells.