Toward a machine learning model for a primary diagnosis of Guillain-Barré syndrome subtypes.

Guillain-Barré Syndrome (GBS) is a neurological disorder affecting people of any age and sex, mainly damaging the peripheral nervous system. GBS is divided into several subtypes, in which only four are the most common, demanding different treatments. Identifying the subtype is an expensive and time-consuming task. Early GBS detection is crucial to save the patient's life and not aggravate the disease. This work aims to provide a primary screening tool for GBS subtypes fast and efficiently without complementary invasive methods, based only on clinical variables prospected in consultation, taken from clinical history, and based on risk factors. We conducted experiments with four classifiers with different approaches, five different filters for feature selection, six wrappers, and One versus All (OvA) classification. For the experiments, we used a data set that includes 129 records of Mexican patients and 26 clinical representative variables. Random Forest filter obtained the best results in each classifier for the diagnosis of the four subtypes, in the same way, this filter with the SVM classifier achieved the best result (0.6840). OvA with SVM classifier reached a balanced accuracy of 0.8884 for the Miller-Fisher (MF) subtype.

Periodontal disease as a predictor of chronic kidney disease (CKD) stage in older adults.

OBJECTIVE: The aim of this study was to evaluate periodontal disease as a predictor of chronic kidney disease (CKD) stage in older adults. METHODS: A total of 1159 adults aged 65 to 80 years and diagnosed with periodontal disease and CKD (stages 1, 2, and 3) were randomly selected for a cross-sectional study. Periodontal status was assessed using the Community Periodontal Index of Treatment Needs (CPITN) and CKD was staged using the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) guidelines. RESULTS: In patients with stage 1 CKD, the odds ratios (ORs) (95% confidence intervals [CIs]) for CPITN-1, CPITN-2, CPITN-3, and CPITN-4 were 1.13 (0.83-1.55), 1.47 (1.13-1.81), 1, and 1, respectively. In patients with stage 2 CKD, the ORs (95% CIs) for CPITN-1, CPITN-2, CPITN-3, and CPITN-4 were 1.49 (1.14-1.93), 1.37 (1.02-1.78), 3.07 (2.81-3.25), and 3.65 (3.49-3.71), respectively. In patients with stage 3 CKD, the ORs (95% CIs) for CPITN-1, CPITN-2, CPITN-3, and CPITN-4 were 1, 1, 4.61 (4.47-5.21), and 5.23 (5.14-5.47), respectively. CONCLUSION: The highest CPITN values (CPITN-3 and CPITN-4) were associated with CKD stages 2 and 3. Thus, periodontal disease may be associated with progression of CKD.

Probióticos y prebióticos: rol en la terapéutica de la enfermedad diarreica aguda infantil / Probiotics and prebiotics: its role in childhood acute diarrheal disease therapy

RESUMEN: La enfermedad diarreica aguda infantil (EDAI), constituye un problema de salud pública, representando la 2ª causa de morbimortalidad infantil en menores de 5 años, en el Ecuador. La hidratación oral y parenteral en los niños hospitalizados bajo normas de administración de conformidad con el grado de deshidratación y pérdida de peso, así como medidas preventivas como la vacunación obligatoria contra el rotavirus, han contribuido a disminuir, pero no a solucionar este problema de salud infantil. Múltiples factores contribuyen para que no se resuelva: socioeconómicos, educacionales, el destete temprano y malas prácticas alimenticias, entre otros. Últimos estudios han propuesto la utilización de probióticos que contribuyan a disminuir el problema sugieriendo el usode Saccharomyces boulardii (SB), asociado a un prebiótico; lo que permitiría acortar el tiempo de tratamiento de una EDAI; por lo que la simbiosis entre SB y un prebiótico denominado fructooligosacárido (FOS), podría ser una alternativa para reducir costos y complicaciones. Una alternativa para medir el curso clínico de una EDAI en infantes es la escala BITTS, de reciente creación y fácil aplicación por clínicos. El objetivo de este manuscrito fue resumir la evidencia existente respecto del rol de losprobióticos y prebióticos en la terapéutica de de la EDAI.

SUMMARY: In Ecuador childhood acute diarrheal disease (CADD) constitutes a serious public health problem, representing the 2nd cause of infant morbidity and mortality in children under 5 years of age. Oral and parenteral hydration in hospitalized children, with standard treatments according to their degree of dehydration and weight loss, as well as preventive measures such as mandatory vaccination against rotavirus, have contributed to a decrease. Nevertheless, this childhood disease has still not been resolved. There are multiple contributing factors involved that prevent complete eradication of the disease Among these are socio-economic problems, education, early weaning and poor feeding practices, all of which continue to affect infants. Recent studies have proposed the use of probiotics that help reduce the problem and it has been suggested that Saccharomyces boulardii (SB), associated with a prebiotic, would reduce the treatment time of an CADD. Therefore, the symbiosis between the SB probiotic and a prebiotic called fructo- oligosaccharide (FOS) could be an alternative to reduce complications and reduce costs. An alternative to measure the clinical course of an CADD in infants is the BITTS scale, which was recently created and can easily be applied by clinicians. The aim of this manuscript was to summarize the existing evidence regarding the role of PROBIOTICS and prebiotics in the treatment of CADD.

[Relationship between the frequency of work-related stress and prevalence of functional dyspepsia in Lima Geriatric Army Hospital]. / Estrés laboral y su correlación con la prevalencia de dispepsia funcional en militares en actividad que acudieron al hospital geriátrico del ejército.

OBJECTIVE: To determine the relationship between the frequency of work-related stress and prevalence of functional dyspepsia in a sample of 218 military older 50 years in 2010 in Lima Military Hospital Geriatric. MATERIALS AND METHODS: Descriptive and explanatory study and for the data collection on stress, were used the Vital Events Scale Holmes-Rahe and clinical records for clinical and upper endoscopy registration that comply the criteria of Rome III for functional dyspepsia. For processing and data analysis the statistical software package SPSS (Statistical Package for Social Sciences) was used. RESULTS: 100% of military showed some level of work stress during the study year; thus, 36.7% had a high level, 31.2% medium or moderate level, and 32.1% had low stress level; these percentages medium and high stress levels accounted for 67.9%. These results establish that job stress is a common discomfort in the study population (tabulated Chi2 = 3.841, chi2 observed = 27,908). Regarding functional dyspepsia prevalence of 37.2%, which indicates that it is a common condition in those military (tabular Z = 1.96, Z c = 9.163) it was determined. CONCLUSIONS: There is a significant relationship between the frequency of work-related stress and prevalence of functional dyspepsia in military activity in older than 50 years (tabulated Chi2 = 5.991, chi2 observed = 28,878, contingency coefficient = 0.342).

Estrés laboral y su correlación con la prevalencia de dispepsia funcional en militares en actividad que acudieron al hospital geriátrico del ejército / Relationship between the frequency of work-related stress and prevalence of functional dyspepsia in Lima Geriatric Army Hospital

Objetivo: Determinar la relación existente entre la frecuencia de estrés laboral y la prevalencia de dispepsia funcional en una muestra de 218 militares mayores de 50 años durante el año 2010 en el Hospital Militar Geriátrico de Lima. Materiales y métodos: Investigación descriptiva- explicativa; para la obtención de datos acerca del estrés se empleó la Escala de Sucesos Vitales de Holmes-Rahe y fichas clínicas para el registro clínico y de endoscopia alta que cumplan criterios de Roma III para dispepsia funcional. Para el procesamiento y análisis de datos se empleó el paquete de programas estadísticos SPSS (Statistical Packagefor Social Sciences). Resultados: el 100% de militares presentaron algún nivel de estrés laboral durante el año de estudio; así, el 36,7% presentó un alto nivel, el 31,2% nivel medio o moderado, y el 32,1% presentó nivel bajo de estrés; de estos porcentajes los niveles medio y alto de estrés representaron el 67,9%. Estos resultados permiten establecer que el estrés laboral es un malestar frecuente en la población estudiada (Chi2 tabular = 3,841, chi2 observado = 27,908). Con relación a la dispepsia funcional se determinó una prevalencia de 37,2%, porcentaje que indica que es una patología frecuente en dichos militares (Z tabular = 1,96, Zc = 9,163). Conclusiones: Existe una relación significativa entre la frecuencia de estrés laboral y la prevalencia de dispepsia funcional en militares en actividad mayores de 50 años (Chi2 tabular= 5,991, chi2 observado =28,878, coeficiente de contingencia=0,342).

Objective: To determine the relationship between the frequency of work-related stress and prevalence of functional dyspepsia in a sample of 218 military older 50 years in 2010 in Lima Military Hospital Geriatric. Materials and methods: Descriptive and explanatory study and for the data collection on stress, were used the Vital Events Scale Holmes-Rahe and clinical records for clinical and upper endoscopy registration that comply the criteria of Rome III for functional dyspepsia. For processing and data analysis the statistical software package SPSS (Statistical Package for Social Sciences) was used. Results: 100% of military showed some level of work stress during the study year; thus, 36.7% had a high level, 31.2% medium or moderate level, and 32.1% had low stress level; these percentages medium and high stress levels accounted for 67.9%. These results establish that job stress is a common discomfort in the study population (tabulated Chi2 = 3.841, chi2 observed = 27,908). Regarding functional dyspepsia prevalence of 37.2%, which indicates that it is a common condition in those military (tabular Z = 1.96, Z c = 9.163) it was determined. Conclusions: There is a significant relationship between the frequency of work-related stress and prevalence of functional dyspepsia in military activity in older than 50 years (tabulated Chi2 = 5.991, chi2 observed = 28,878, contingency coefficient = 0.342).

Relative stability of human centrins and its relationship to calcium binding.

Centrins are calcium binding proteins that belong to the EF-hand superfamily with diverse biological functions. Herein we present the first systematic study that establishes the relative stability of related centrins via complementary biophysical techniques. Our results define the stepwise molecular behavior of human centrins by two-dimensional infrared (2D IR) correlation spectroscopy, the change in heat capacity and enthalpy of denaturation by differential scanning calorimetry, and the relative stability of the helical regions of centrins by circular dichroism. More importantly, 2D IR correlation spectroscopy provides unique information about the similarities and differences in dynamics between these related proteins. The thermally induced molecular behavior of human centrins can be used to predict biological target interactions that have a relative dependence on calcium affinity. This information is essential for understanding why certain isoforms may be used to rescue a phenotype and therefore also for explaining the different functions these proteins may have in vivo. Furthermore, this comparative approach can be applied to the study of recombinant therapeutic protein candidates for the treatment of disease states.

The structure, molecular dynamics, and energetics of centrin-melittin complex.

Centrin is a calcium binding protein (CaBP) belonging to the EF-hand superfamily. As with other proteins within this family, centrin is a calcium sensor with multiple biological target proteins. We chose to study Chlamydomonas reinhardtii centrin (Crcen) and its interaction with melittin (MLT) as a model for CaBP complexes due to its amphipathic properties. Our goal was to determine the molecular interactions that lead to centrin-MLT complex formation, their relative stability, and the conformational changes associated with the interaction, when compared to the single components. For this, we determined the thermodynamic parameters that define Crcen-MLT complex formation. Two-dimensional infrared (2D IR) correlation spectroscopy were used to study the amide I', I'*, and side chain bands for (13)C-Crcen, MLT, and the (13)C-Crcen-MLT complex. This approach resulted in the determination of MLT's increased helicity, while centrin was stabilized within the complex. Herein we provide the first complete molecular description of centrin-MLT complex formation and the dissociation process. Also, discussed is the first structure of a CaBP-MLT complex by X-ray crystallography, which shows that MLT has a different binding orientation than previously characterized centrin-bound peptides. Finally, all of the experimental results presented herein are consistent with centrin maintaining an extended conformation while interacting with MLT. The molecular implications of these results are: (1) the recognition of hydrophobic contacts as requirements for initial binding, (2) minimum electrostatic interactions within the C-terminal end of the peptide, and (3) van der Waals interactions within MLTs N-terminal end are required for complex formation.

[Expression of epidermal growth factor receptor in renal biopsy from patients with adolescent nephronophthisis]. / Expresión del receptor del factor de crecimiento epidérmico en biopsias renales de pacientes con nefronoptisis del adolescente.

INTRODUCTION: In Venezuela has been described a new form of nephronophthisis, called adolescent nephronophthisis, with clinical and histological findings very similar to others varieties described. However, pathogenesis in not well known. The aim of this study was to determine the expression of human epidermal growth factor receptor (EGFR) in tubular epithelial cells of patients with adolescent nephronophthisis. METHODS: Renal biopsies of 8 patients with adolescent nephronophthisis were studied by immunohistochemistry to determine renal expression of EGFR. RESULTS: In all patients, there was no expression of epidermal growth factor receptor. CONCLUSION: These findings indicate a deficiency of growth factor receptor in undifferentiated epithelial cells, which could be one factor in the development of cysts in nephronophthisis.

The kinetics of the hydrogen/deuterium exchange of epidermal growth factor receptor ligands.

Five highly homologous epidermal growth factor receptor ligands were studied by mass spectral analysis, hydrogen/deuterium (H/D) exchange via attenuated total reflectance Fourier transform-infrared spectroscopy, and two-dimensional correlation analysis. These studies were performed to determine the order of events during the exchange process, the extent of H/D exchange, and associated kinetics of exchange for a comparative analysis of these ligands. Furthermore, the secondary structure composition of amphiregulin (AR) and heparin-binding-epidermal growth factor (HB-EGF) was determined. All ligands were found to have similar contributions of 3(10)-helix and random coil with varying contributions of beta-sheets and beta-turns. The extent of exchange was 40%, 65%, 55%, 65%, and 98% for EGF, transforming growth factor-alpha (TGF-alpha), AR, HB-EGF, and epiregulin (ER), respectively. The rate constants were determined and classified as fast, intermediate, and slow: for EGF the 0.20 min(-1) (Tyr), 0.09 min(-1) (Arg, beta-turns), and 1.88 x 10(-3) min(-1) (beta-sheets and 3(10)-helix); and for TGF-alpha 0.91 min(-1) (Tyr), 0.27 min(-1) (Arg, beta-turns), and 1.41 x 10(-4) min(-1) (beta-sheets). The time constants for AR 0.47 min(-1) (Tyr), 0.04 min(-1) (Arg), and 1.00 x 10(-4) min(-1) (buried 3(10)-helix, beta-turns, and beta-sheets); for HB-EGF 0.89 min(-1) (Tyr), 0.14 min(-1) (Arg and 3(10)-helix), and 1.00 x 10(-3) min(-1) (buried 3(10)-helix, beta-sheets, and beta-turns); and for epiregulin 0.16 min(-1) (Tyr), 0.03 min(-1) (Arg), and 1.00 x 10(-4) min(-1) (3(10)-helix and beta-sheets). These results provide essential information toward understanding secondary structure, H/D exchange kinetics, and solvation of these epidermal growth factor receptor ligands in their unbound state.