Burden, Outcome, and Comorbidities of Extrahepatic Manifestations in Hepatitis B Virus Infections.

Hepatitis B virus (HBV) infections affect approximately 296 million people around the world, and the prevalence of any past or present HBV infection during the years 2015-2018 was as high as 4.3%. Acute HBV infection often presents with nonspecific symptoms and is usually self-limited, but 5% of patients can have persistent infections leading to chronic HBV infection and the risk of turning into chronic HBV infection is significantly higher in babies with vertical transmission (95%). Patients with chronic HBV infection are usually asymptomatic, but 15 to 40% of chronic HBV carriers develop cirrhosis and/or hepatocellular carcinoma. In addition to liver-related disorders, HBV is also associated with several extrahepatic complications, including glomerulonephritis, cryoglobulinemia, neurologic disorders, psychological manifestations, polyarthritis, and dermatologic disorders. Making the diagnosis of HBV can be challenging since patients with chronic infections can remain symptom-free for decades before developing cirrhosis or hepatocellular carcinoma, and patients with acute HBV infection may have only mild, nonspecific symptoms. Therefore, understanding how this virus causes extrahepatic complications can help clinicians consider this possibility in patients with diverse symptom presentations. The pathophysiology of these extrahepatic disorders likely involves immune-related tissue injury following immune complex formation and inflammatory cascades. In some cases, direct viral infection of extrahepatic tissue may cause a clinical syndrome. Currently, the American Association for the Study of Liver Diseases recommends treatment of chronic HBV infections with interferon therapy and/or nucleos(t)ide analogs, and this treatment has been reported to improve some extrahepatic disorders in some patients with chronic HBV infection. These extrahepatic complications have a significant role in disease outcomes and increase medical costs, morbidity, and mortality. Therefore, understanding the frequency and pathogenesis of these extrahepatic complications provides important information for both specialists and nonspecialists and may help clinicians identify patients at an earlier stage of their infection.

Análisis de la crisis política de Brasil del 2013 al 2018: una perspectiva psicosociológica / Analysis of the political crisis in Brazil from 2013 to 2018: a psychosociological perspective / Análise da crise política no Brasil de 2013 a 2018: uma perspectiva psicossociológica

El texto analiza la crisis política que enfrentó Brasil, del 2013 al 2018. Se analiza cómo se vivió la crisis y cómo se articularon en la conciencia de los ciudadanos los diferentes elementos que constituyen esa coyuntura. Se realizó un estudio empírico con 158 universitarios para entender cómo se traduce la lucha ideológica en Brasil en la opinión de las personas sobre los tipos de conflicto político y cómo se reflejan estas representaciones en las percepciones sobre la crisis. Los datos muestran la existencia de una fuerte polarización política y corroboran que la forma en que el individuo se ubica en el espacio político es muy importante para comprender el significado que le dará a la crisis. Finalmente, el estudio muestra la importancia de las representaciones de la estructura social del conflicto como matriz ideológica subyacente al comportamiento político.

This text analyzes the political crisis that Brazil faced, from 2013 to 2018. It analyzes how the crisis was experienced and how different elements that constitute this context were articulated in citizens consciousness. An empirical study was carried out with 158 undergraduate students in order to understand how the ideological struggle in Brazil translates into people's opinion about the types of political conflict and how these representations are reflected in perceptions about the crisis. The data show the existence of a strong political polarization and corroborate that the way in which individuals locate themselves in the political space is very important to understand the meaning that they will give to the crisis. Finally, the study shows the importance of the representations of the social structure of the conflict as an ideological matrix underlying political behavior.

O texto analisa a crise política que o Brasil enfrentou, de 2013 a 2018. Analisa como a crise foi vivida e como os diferentes elementos que compõem essa situação foram articulados na consciência dos cidadãos. Foi realizado um estudo empírico com 158 estudantes universitários para entender como a luta ideológica no Brasil se traduz na opinião das pessoas sobre os tipos de conflito político e como essas representações se refletem nas percepções da crise. Os dados mostram a existência de uma forte polarização política e corroboram que a maneira pela qual o indivíduo está localizado no espaço político é muito importante para entender o significado que dará à crise. Por fim, o estudo mostra a importância das representações da estrutura social do conflito como matriz ideológica subjacente ao comportamento político.

The phenotypic spectrum of AMER1-related osteopathia striata with cranial sclerosis: The first Canadian cohort.

Osteopathia striata with cranial sclerosis (OSCS; OMIM# 300373) is a rare X-linked disorder caused by mutations of the AMER1 gene. OSCS is traditionally considered a skeletal dysplasia, characterized by cranial sclerosis and longitudinal striations in the long bone metaphyses. However, OSCS affects many body systems and varies significantly in phenotypic severity between individuals. This case series focuses on the phenotypic presentation and development of individuals with OSCS. We provide an account of 12 patients with OSCS, ranging from 5 months to 38 years of age. These patients were diagnosed with OSCS after genetic testing confirmed pathogenic mutations in AMER1. Patient consent was obtained for photos and participation. Data were collected regarding perinatal history, dysmorphic features, and review of systems. This case series documents common facial dysmorphology, as well as rare extraskeletal features of OSCS, including two patients with intestinal malrotation and two patients with pyloric stenosis. We share four apparently nonmosaic males with OSCS (one de novo and three maternal variants). We also provide a clinical update on a patient who was previously published by Chénier et al. (2012). American Journal of Medical Genetics Part A, 158, 2946-2952. More research is needed to investigate the links between genotype and phenotype and assess the long-term comorbidities and overall quality of life of individuals with OSCS.

Blood pressure in adults with short stature skeletal dysplasias.

Hypertension, compounded by obesity, contributes to cardiovascular disease and mortality. Data describing hypertension prevalence in adults with short stature skeletal dysplasias are lacking, perhaps due to poor fit of typical adult blood pressure cuffs on rhizomelic or contracted upper extremities. Through health screening research, blood pressure was measured in short stature adults attending support group meetings and skeletal dysplasia clinics. Blood pressure was measured with a commercially available, narrower adult cuff on the upper and/or lower segment of the arm. Height, weight, age, gender, diagnosis, exercise, and medications were collected. Subjects were classified as normotensive, prehypertensive, or hypertensive for group analysis; no individual clinical diagnoses were made. In 403 short stature adults, 42% were hypertensive (systolic >140, diastolic >90 OR taking antihypertensive medications). For every BMI unit and 1 kg weight increase in males, there was a 9% and an 8% increase, respectively, in the odds of hypertension versus normotension. In females, the increase was 10% and 6%, respectively. In those with achondroplasia, the most common short stature dysplasia, males (n = 106) had 10% greater odds of hypertension versus normotension for every BMI unit and kilogram increase. In females with achondroplasia (n = 128), the odds of hypertension versus normotension was 8% greater for each BMI unit and 7% for each additional kilogram. These data suggest a high population prevalence of hypertension among short stature adults. Blood pressure must be monitored as part of routine medical care, and measuring at the forearm may be the only viable clinical option in rhizomelic short stature adults with elbow contractures.

Field Evaluation of the Effectiveness of an Oral Toltrazuril and Iron Combination (Baycox® Iron) in Maintaining Weaning Weight by Preventing Coccidiosis and Anaemia in Neonatal Piglets.

Effectiveness of an oral combination of toltrazuril and iron dextran (Baycox(®) Iron) to maintain weaning weight by preventing coccidiosis caused by Isospora suis and iron-deficiency anaemia in neonatal piglets was investigated on three commercial pig farms with a history of coccidiosis: two in Mexico and one in Brazil. On day (SD) 2 of life, piglets were randomised within litter by bodyweight to treatment or control group. On SD 3 piglets allocated to the control group (CG) each received 1 mL Baycox(®), containing 50 mg/mL toltrazuril orally and commercially available iron (200 mg/piglet) by intramuscular injection. Piglets allocated to the treatment group (TG) each received 1 mL toltrazuril and iron combination orally (Baycox(®) Iron) containing 50 mg/mL toltrazuril and 228 mg iron as iron dextran. All piglets had access to creep feed. 6493 piglets completed the study. Bodyweight at weaning on SD 21 of piglets treated with the oral toltrazuril and iron combination was confirmed to be non-inferior to the control treatment with <1 % difference between group mean body weights. Faecal samples from at least 10 % of litters on SD 14 demonstrated control of coccidiosis. Haemoglobin levels on SD 21 were lower in the oral toltrazuril and iron combination treated piglets compared to control levels but above minimum haemoglobin levels to maintain health. There was no difference in mortality between the two groups. This large scale field evaluation clearly demonstrated the effectiveness of a combination of oral toltrazuril and iron (Baycox(®) Iron) in maintaining body weight at weaning compared to conventional treatment. The combination was effective in preventing coccidiosis and anaemia and thus provides a valuable alternative that reduces stressful events in neonatal piglets. There were no product related adverse events.

Biodiesel from waste cooking oil in Mexico City.

The aim of this article is to evaluate the potential use of biodiesel produced from waste cooking oil in Mexico City. The study is divided in two main areas: the analysis of a waste cooking oil collection pilot project conducted in food markets of a Mexico City region; and the exhaust emissions performance of biodiesel blends measured in buses of the Mexico City public bus transportation network (RTP). Results from the waste cooking oil collection pilot project show that oil quantities disposed depend upon the type of food served and the operational practices in a cuisine establishment. Food markets' waste cooking oil disposal rate from fresh oil is around 10%, but with a very high standard deviation. Emission tests were conducted using the Ride-Along-Vehicle-Emissions-Measuring System in two different types of buses while travelling a regular route. Results shows that the use of biodiesel blends reduces emissions only for buses that have exhaust gas recirculation systems, as analysed by repeated measure analysis of variance. The potential use in Mexico City of waste cooking oil for biodiesel is estimated to cover 2175 buses using a B10 blend.

Overexpression of MEOX2 and TWIST1 is associated with H3K27me3 levels and determines lung cancer chemoresistance and prognosis.

Lung cancer is the leading cause of death from malignant diseases worldwide, with the non-small cell (NSCLC) subtype accounting for the majority of cases. NSCLC is characterized by frequent genomic imbalances and copy number variations (CNVs), but the epigenetic aberrations that are associated with clinical prognosis and therapeutic failure remain not completely identify. In the present study, a total of 55 lung cancer patients were included and we conducted genomic and genetic expression analyses, immunohistochemical protein detection, DNA methylation and chromatin immunoprecipitation assays to obtain genetic and epigenetic profiles associated to prognosis and chemoresponse of NSCLC patients. Finally, siRNA transfection-mediated genetic silencing and cisplatinum cellular cytotoxicity assays in NSCLC cell lines A-427 and INER-37 were assessed to describe chemoresistance mechanisms involved. Our results identified high frequencies of CNVs (66-51% of cases) in the 7p22.3-p21.1 and 7p15.3-p15.2 cytogenetic regions. However, overexpression of genes, such as MEOX2, HDAC9, TWIST1 and AhR, at 7p21.2-p21.1 locus occurred despite the absence of CNVs and little changes in DNA methylation. In contrast, the promoter sequences of MEOX2 and TWIST1 displayed significantly lower/decrease in the repressive histone mark H3K27me3 and increased in the active histone mark H3K4me3 levels. Finally these results correlate with poor survival in NSCLC patients and cellular chemoresistance to oncologic drugs in NSCLC cell lines in a MEOX2 and TWIST1 overexpression dependent-manner. In conclusion, we report for the first time that MEOX2 participates in chemoresistance irrespective of high CNV, but it is significantly dependent upon H3K27me3 enrichment probably associated with aggressiveness and chemotherapy failure in NSCLC patients, however additional clinical studies must be performed to confirm our findings as new probable clinical markers in NSCLC patients.

Hyperphosphatasia with seizures, neurologic deficit, and characteristic facial features: Five new patients with Mabry syndrome.

Persistent hyperphosphatasia associated with developmental delay and seizures was described in a single family by Mabry et al. 1970 (OMIM 239300), but the nosology of this condition has remained uncertain ever since. We report on five new patients (two siblings, one offspring of consanguineous parents, and two sporadic patients) that help delineate this distinctive disorder and provide evidence in favor of autosomal recessive inheritance. Common to all five new patients is facial dysmorphism, namely hypertelorism, a broad nasal bridge and a tented mouth. All patients have some degree of brachytelephalangy but the phalangeal shortening varies in position and degree. In all, there is a persistent elevation of alkaline phosphatase activity without any evidence for active bone or liver disease. The degree of hyperphosphatasia varies considerably ( approximately 1.3-20 times the upper age-adjusted reference limit) between patients, but is relatively constant over time. In the first family described by Mabry et al. 1970, at least one member was found to have intracellular inclusions on biopsy of some but not all tissues. This was confirmed in three of our patients, but the inclusions are not always observed and the intracellular storage material has not been identified.

Valores psicossociais e orientação à dominância social: um estudo acerca do preconceito / Psychosocial values and social dominance orientation: a study about prejudice

O objetivo central do presente estudo foi analisar as relações existentes entre o preconceito, através da orientação à dominância social, e os valores psicossociais, a partir de quatro sistemas, o religioso, o materialista, o pós-materialista e o hedonista. Participaram deste estudo 205 estudantes universitários do curso de psicologia da cidade de João Pessoa - PB. Estes responderam à escala de orientação à dominância social, ao questionário de valores psicossociais e a um conjunto de questões sócio-demográficas. Os resultados indicaram relações parciais entre estas variáveis, sendo a orientação à dominância social diretamente associada aos valores materialistas e contrariamente associada aos valores pós-materialistas. As considerações apresentam o preconceito como resultado das construções ideológicas amplamente compartilhadas pelos grupos sociais.

The aim of this study was to analyze the relationships among prejudice and psychosocial values, by means of the orientation of social dominance, from four systems, the religious, the materialist, the post-materialist and, the hedonist. For this particular study, 205 undergraduate Psychology students were chosen from the city of João Pessoa - PB. They answered the social dominance orientation scale, psychosocial value questionnaire, and a set of social-demographic questions. The results presented partial relations among these variables, the social dominance orientation was directly associated with the materialist values and inversely associated with the post-materialistic values. The considerations present prejudice as the consequence of ideological constructions amply shared by social groups.

Seguimiento a largo plazo en 413 pacientes con vía accesoria atrioventricular sometidos a ablación con radiofrecuencia

Objetivo: se analizan los resultados clínicos y el seguimiento a largo plazo de los pacientes que fueron sometidos a ablación endocárdica mediante radiofrecuencia para el tratamiento de la taquicardia paroxística supraventricular por vía accesoria atrioventricular. Material y métodos: se incluyeron 413 pacientes a quienes se les realizó ablación con radiofrecuencia de vías accesorias atrioventricular de abril de 1992 a diciembre de 1995. Resultados: de los 413 pacientes seleccionados, 234 (57%) eran hombres y 179 (43%) eran mujeres, con edad promedio de 31.3 ± 16.3 años (límites 2 a 69 años). Se localizó un total de 437 vías accesorias atrioventriculares, 389 (93)% eran únicas y en 24 enfermos estuvieron presentes dos vías accesorias. La ablación tuvo éxito inmediato en 381 vías atrioventriculares (87%), durante el seguimiento promedio de siete años, se observó recurrencia de 51 vías atrioventriculares (13%), de estas 41 (80%) recurrieron en los primeros tres meses. A cincuenta y seis pacientes se les realizó una segunda sesión de ablación, con éxito de 35 (62.5%) y nueva recurrencia en 2 (5.7%). Son 365 vías accesorias (83.5) que permanecen sin recurrencia de taquicardia o preexcitación. Conclusiones: durante el seguimiento, los efectos de la ablación exitosa con RF se preservan en el tiempo. La taquicardia identificada en recurrencia siempre correspondió al mecanismo de reentrada a través de la vía accesoria.

Objective: the aim of this study was shown clinical characteristics and follow-up of patients with atrioventricular reentrant tachycardia (AVRT) who underwent radiofrequency catheter ablation (RCA) therapy. Material and Methods: from April 1992 to December 1995, 413 patients with AVRT underwent RCA therapy. Results: two hundred thirty four men (57%) and one hundred seventy nine women (43%) aged 31.3 ± 16-3 years were studied. 437 single accessory pathways were found; 24 had multiple accessory pathways. Ablation therapy was successful in 381 accessory pathways. During follow-up of 7 years, AVRT recurred in 51 patients (13%) and in 80% this occurred within the first 3 months after the procedure. 56 patients underwent a second RCA therapy with success in 35 patients (83.5); two reoccurred (5.7%); 365 accessory pathways (83.5) remained without evidence of preexcitation AVRT. Conclusions: during follow-up, these patients with successful ablation therapy remained without symptoms. In patients who underwent a second RCA therapy, atrioventricular reentrant mechanism was always present.

Actividad antibacteriana de la sangre de grado (Croton lechleri) frente al Helicobacter pylori / Antibacterial activity of the blood of degree (Croton Lechleri) opposite to the helicobacter pylori

Actualmente ha sido aceptado el rol patogénico de Helicobacter pylori en la generación de gastritis y úlcera gástrica, así como la relación directa entre la erradicación de la bacteria y la ausencia de complicaciones y posteriores recurrencias. Considerando la actividad anti ulcerosa atribuida a la sangre de grado (Croton lecheri). Objetivo: Determinar la actividad antibacteriana de la sangre de grado frente a la bacteria. Material y métodos: Se trabajó con 41 cepas de Helicobacter pylori de origen clínico y cuatro presentaciones de sangre de grado. En una primera etapa se determinó de manera cualitativa el efecto inhibidor del crecimiento, posteriormente se determinó la concentración mínima inhibitoria (CIM) y la concentración mínima bactericida (CMB) de la sangre de grado frente a la bacteria. Resultados: Los resultados muestran que la sangre de grado inhibe el crecimiento de Helicobacter pylori en concentraciones elevadas, también se determinó el efecto bactericida del producto concentrado. Conclusión: Estos resultados sugieren que la actividad cicatrizante de la sangre de grado probada en estudios anteriores y complementada con la actividad antibacteriana determinada en el presente estudio, serían las resposnables de la capacidad curativa de este producto frente a las úlceras gástricas.

Ergotismo: ¿iatrogenia o idiosincrasia? / Ergotism: Iatrogenic or idiosyncrasy?

El ergotismo continúa siendo una causa rara de insuficiencia arterial crónica y aguda en pacientes en edad productiva, que si no es detectada y tratada a tiempo puede causar daño neurológico permanente o pérdida de la extremidad y como consecuencia invalidez del paciente. En un lapso de dos años se recibieron en el servicio cuatro pacientes con diagnóstico de ergotismo, tres mujeres y un hombre, se manejaron con interrupción de la ergotamina, vasodilatadores y dos de ellos con simpatectomía lumbar; dos de los pacientes presentaron secuelas y determinar si el ergotismo es una iatrogenia causada por el uso prolongado de este medicamento