Peritoneal tuberculosis in an immunocompetent patient: A case report.

Introduction: Tuberculosis is endemic in Colombia, the prevalence of its pulmonary form in immunocompetent hosts is high, and peritoneal compromise instead is rare and difficult to diagnose. Case presentation: A 24-year-old female patient living in a rural area presented to the emergency department with constitutional and gastrointestinal symptoms, including bloating, diarrhea, significant weight loss, nocturnal diaphoresis, and gradual onset of ascites with abdominal pain. Diagnostic workup, including paracentesis, a transvaginal ultrasound, and an abdominal CT scan, did not suggest malignancy or portal hypertension. However, diagnostic laparoscopy revealed a miliary pattern comprising the parietal and pelvic peritoneum, uterus, fallopian tubes, and major omentum suggestive of peritoneal tuberculosis. Anti-tuberculosis therapy was initiated with subsequent microbiological confirmation. Conclusion: Abdominal compromise by tuberculosis is a diagnostic challenge, especially in patients with no apparent risk factors. The clinical manifestations and paraclinical data may be unspecific or inconclusive, requiring peritoneal biopsy and empirical treatment before definitive confirmation.

Prevalencia de Helicobacter pylori en pacientes llevados a endoscopia de vías digestivas altas en un hospital de referencia en Cali, Colombia, en 2020 / Prevalence of Helicobacter pylori in patients undergoing upper digestive tract endoscopy at a referral hospital in Cali, Colombia, in 2020

Resumen Introducción: la infección por Helicobacter pylori tiene una alta prevalencia y distribución a nivel mundial. Por su asociación con el desarrollo de adenocarcinoma gástrico, las actualizaciones sobre su prevalencia son de interés para el médico internista o gastroenterólogo, así como para la generación de políticas públicas. Este estudio midió la prevalencia de H. pylori y evaluó su asociación con hallazgos endoscópicos e histopatológicos en adultos con indicación de endoscopia de vías digestivas altas (EVDA). Metodología: estudio de cohorte analítica para describir la prevalencia de H. pylori y evaluar factores de riesgo asociados a esta infección en pacientes adultos sometidos a EVDA ambulatoria por cualquier indicación médica en la unidad de endoscopia de un hospital universitario de cuarto nivel de complejidad entre junio y diciembre de 2020. Se describen hallazgos endoscópicos, histopatológicos y la prevalencia de H. pylori. Para explorar los factores de riesgo se usó la prueba chi cuadrado (χ2) para evaluar diferencias en las proporciones y las pruebas t de Student y U de Mann-Whitney para las variables continuas según su distribución. Resultados: 613 pacientes cumplieron los criterios de selección y fueron incluidos en el análisis. La indicación más frecuente de EVDA fue dispepsia. La prevalencia de H. pylori fue de 38,5% (intervalo de confianza [IC] 95%: 34,7%-42,4%). Conclusión: H. pylori es un tema de gran interés en las patologías gastrointestinales. La búsqueda endoscópica debe ser en el antro y cuerpo. Su presencia fue mayor en pacientes con esófago normal, gastritis nodular folicular, úlcera duodenal e inflamación aguda al estudio histológico. Se requieren más estudios que complementen el comportamiento epidemiológico local.

Abstract Introduction: Helicobacter pylori infection has a high prevalence and distribution worldwide. Due to its association with the development of gastric adenocarcinoma, updates on its prevalence are of interest to the internist or gastroenterologist and policymaking. This study measured the prevalence of H. pylori and evaluated its association with endoscopic and histopathological findings in adults with an indication for upper GI endoscopy (EGD). Materials and methods: This analytical cohort study describes the prevalence of H. pylori and assesses risk factors associated with this infection in adult patients undergoing outpatient EGD for any medical indication in the endoscopy unit of a quaternary care university hospital between June and December 2020. Endoscopic and histopathological findings and the prevalence of H. pylori are described. To explore the risk factors, the chi-square (χ2) test was used to evaluate differences in proportions and the Student's t and Mann-Whitney U tests for continuous variables according to their distribution. Results: 613 patients met the selection criteria and were included in the analysis. The most frequent indication for EGD was dyspepsia. The prevalence of H. pylori was 38.5% (95% confidence interval [CI]: 34.7-42.4%). Conclusion: H. pylori is a topic of great interest in gastrointestinal pathologies. The endoscopic search should take place in the antrum and body. Its presence was most common in patients with a normal esophagus, follicular nodular gastritis, duodenal ulcer, and acute inflammation upon the histological study. More studies are required to complement the local epidemiological behavior.

Long term cutaneous complications related to bone conduction hearing implants. A retrospective study (2004-2018).

OBJECTIVE: The aim of this study was to establish the frequency of cutaneous complications due to surgically implanted bone conduction hearing aids in recipients treated at a tertiary otolaryngology center. Additionally, based on the literature review, we propose a scale to standardize the report of cutaneous reactions related to transcutaneous systems to objectify future studies. METHODS: A retrospective chart review was conducted for patients who were implanted with bone conduction hearing systems between 2004 and 2018. Patients with minimum follow up of 6 months were included. Patient demographics, surgical characteristics and clinical course was analyzed by number and skin reactions. Transcutaneous and percutaneous systems were analyzed separately. The study was approved by the local IRB. RESULTS: A total of 104 devices were implanted on 88 patients with an average follow up of 4.04 (range of 0.5 - 10 years). Out of the total of patients, 49 (55.7%) developed at least one episode of inflammatory/infectious skin reaction at surgical incision site. A total of 148 episodes of local infections during the entire follow-up period were registered, mostly mild in severity with no triggering factors identified. The majority of the initial episodes of infection occurred within the first 3 years of follow-up. Out of the total of patients, 47 (53.4%) reported pain at the surgical site at some point throughout follow-up, not associated with clinically evident infection. CONCLUSION: The incidence of skin complications in our series seemed higher compared to previous reports. Minor complications were the most common and responded well to topical treatment. No triggering factors were identified as the cause of the infections, nor to explain the frequency or the severity of such an adverse reaction. Isolated pain was present in the majority of patients with conductive hearing devices, even without signs of active infection. Due to its high incidence it should be assessed in all patients that receive an implant. Based on a search of the literature, a scale to standardize cutaneous complications of transcutaneous implants was undertaken, but further studies are needed to validate such a scale.

Heterotopia de mucosa gástrica en el intestino delgado, hallazgo en videocápsula endoscópica. Reporte de caso / An endoscopic videocapsule finding of heterotopia of the gastric mucosa of the small intestine

Resumen Introducción: la heterotopia de mucosa gástrica se refiere a la localización ectópica de mucosa gástrica en cualquier parte del tracto gastrointestinal. Es una causa poco frecuente de úlceras gastrointestinales y sangrado digestivo oculto. La videocápsula endoscópica se ha convertido en una herramienta fundamental para el estudio del intestino delgado. Métodos: estudio descriptivo de reporte de caso. La información de la historia clínica, reporte de patología y estudios endoscópicos, se extrajo de las bases de datos de la Fundación Valle del Lili. Resultados: paciente masculino de 71 años, en quien se realizó videocápsula endoscópica por un sangrado digestivo oculto y se encontraron segmentos de estenosis y úlceras en el yeyuno. La histopatología reveló la presencia de mucosa gástrica heterotópica. Conclusión: la heterotopia de mucosa gástrica debe considerarse como una causa posible de sangrado del intestino delgado.

Abstract Introduction: Heterotopia of the gastric mucosa refers to an ectopic location of gastric mucosa in any part of the gastrointestinal tract. It is a rare cause of gastrointestinal ulcers and occult digestive bleeding. Endoscopic videocapsules have become fundamental tools for study of the small intestine. Methods: This is a descriptive case study based on information from the medical history, pathology report and endoscopic studies extracted from the databases of the Fundación Valle del Lili in Cali, Colombia. Results: An endoscopic videocapsule was used to examine a 71-year-old male patient who suffered from occult digestive bleeding. Segments of stenosis and ulcers were found in the jejunum and histopathology revealed heterotopic gastric mucosa. Conclusion: Heterotopy of the gastric mucosa should be thought of as a possible cause of bleeding in the small intestine.

Aplicación de la inmunocitoquímica como ayuda diagnóstica: experiencia en hospital universitario de alta complejidad en Cali, Colombia / Application of immunocytochemistry as a diagnostic aid: Experience in a tertiary university hospital in Cali, Colombia

Introducción: La inmunocitoquímica es de gran utilidad para la diferenciación de lesiones benignas y malignas mediante la utilización de anticuerpos específicos que diferencian las células según su origen. Este estudio se realizó con el fin de describir la experiencia de la Fundación Valle del Lili en la aplicación de la inmunohistoquímica al estudio citológico de diferentes tipos de muestra. Materiales y métodos: Se realizó un estudio observacional, descriptivo y retrospectivo de las citologías registradas en la base de datos del departamento de patología de la Fundación Valle del Lili entre diciembre de 2015 y octubre de 2017. Resultados: Se analizaron 54 citologías a las que se efectuó estudio inmunocitoquímico. Se logró realizar tanto bloque celular como botón de citología en base líquida en el 38,88% (n=21) del total de muestras, encontrándose entre los resultados de ambos tipos de citología un coeficiente kappa de Cohen de 0,80 (IC95%: 0,46-1,0), p<0,001. Los marcadores más empleados fueron: Calretinina, MOC-31, EMA, TTF1, PAX8 y calcitonina. De las citologías positivas para malignidad, se realizó diagnóstico definitivo con biopsia al 58,1% (n=25), encontrándose una concordancia muy alta, con un coeficiente kappa de Cohen de 1,0 (IC95%: 1,0-1,0), p<0,001. Discusión: La información aportada por este estudio permite implementar la citología de botón en base líquida para la realización de inmunocitoquímica en los marcadores que fueron evaluables y en los que se encontró concordancia con respecto a la citología en bloque celular. Además, invita a continuar en la búsqueda de conocimiento aportando datos a futuros estudios en esta línea de investigación

Introduction: Immunocytochemistry is very useful in the differentiation of benign and malignant lesions, through the use of specific antibodies that differentiate the cells according to their origin. This study aims to describe the application of immunohistochemistry to the cytological study of different sample types at the Valle del Lili Foundation. Materials and methods: A descriptive, retrospective, observational study was carried out with cytologies registered in the database of the pathology department of the Fundación Valle del Lili, between December 2015 and October 2017. Results: Fifty-four cytological samples with immunocytochemistry were included. It was possible to perform both the cell block and the liquid-based cytology button to 38.88% (n=21) of the total samples, finding from the results of both types of cytology, a Cohen's Kappa coefficient of 0.80 (95%CI: (0.4-1.0), P<.001. The most commonly used markers were: Calretinin, MOC-31, EMA, TTF1, PAX8, and Calcitonin. Out of the cytological studies positive for malignancy, a definitive diagnosis was made with a biopsy in 58.1% (n=25), with a Cohen's Kappa coefficient of 1.0 (95%CI: 1.0-1.0), P<.001. Discussion: This study provided data that permits the implementation of liquid-based cytology button for immunocytochemical studies, using assessable markers with agreement with cell-block cytology. Furthermore, it provides data useful for future research in this field

Riedel's Thyroiditis: Report of Two Cases and Literature Review.

Riedel's thyroiditis is a rare entity consisting of a fibrotic process of the thyroid which can generate gland destruction, infiltration of cervical structures and even airway obstruction. It has been associated with systemic fibrotic disorders, autoimmune diseases, and more recently with spectrum of diseases related to excess of Immunoglobulin G type 4 (IgG4). Two cases of Riedel's thyroiditis by IgG4, confirmed by immunohistochemistry and was managed surgically with favorable results during the follow-up time, are presented. These case descriptions highlight the diagnostic challenge of this disease, describe the response with surgical management, and make a brief update on the subject.

[Application of immunocytochemistry as a diagnostic aid: Experience in a tertiary university hospital in Cali, Colombia]. / Aplicación de la inmunocitoquímica como ayuda diagnóstica: experiencia en hospital universitario de alta complejidad en Cali, Colombia.

INTRODUCTION: Immunocytochemistry is very useful in the differentiation of benign and malignant lesions, through the use of specific antibodies that differentiate the cells according to their origin. This study aims to describe the application of immunohistochemistry to the cytological study of different sample types at the Valle del Lili Foundation. MATERIALS AND METHODS: A descriptive, retrospective, observational study was carried out with cytologies registered in the database of the pathology department of the Fundación Valle del Lili, between December 2015 and October 2017. RESULTS: Fifty-four cytological samples with immunocytochemistry were included. It was possible to perform both the cell block and the liquid-based cytology button to 38.88% (n=21) of the total samples, finding from the results of both types of cytology, a Cohen's Kappa coefficient of 0.80 (95%CI: (0.4-1.0), P<.001. The most commonly used markers were: Calretinin, MOC-31, EMA, TTF1, PAX8, and Calcitonin. Out of the cytological studies positive for malignancy, a definitive diagnosis was made with a biopsy in 58.1% (n=25), with a Cohen's Kappa coefficient of 1.0 (95%CI: 1.0-1.0), P<.001. DISCUSSION: This study provided data that permits the implementation of liquid-based cytology button for immunocytochemical studies, using assessable markers with agreement with cell-block cytology. Furthermore, it provides data useful for future research in this field.

Gestos pesquisantes: ressonâncias de uma intervenção em saúde mental na atenção básica / Research gestures: repercussions of a mental health intervention within primary health care / Gestos investigativos: resonancias de una intervención en salud mental en la atención primaria

Neste artigo, objetivamos relatar a experiência de uma pesquisa participativa, interventiva e cartográfica em saúde mental na atenção básica, problematizando os modos de conhecer e explorando as potencialidades e afetos despertados em campo. Trazemos a trajetória da pesquisa "Qualificação da Saúde Mental na Atenção Básica: análise das práticas de equipes da Região 10-Macrometropolitana/RS a partir do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB)", discutindo especificamente o processo em um dos municípios envolvidos. Adentramos o campo, descentralizando gestos acadêmicos em contato com os descentramentos da atenção básica. Experimentamos composições nesse nível porta de entrada do sistema de saúde, junto a usuários, trabalhadores e gestores, abrindo-nos aos imprevisíveis que exigem invenção e construção de um comum em meio às comunidades e territórios. Tal perspectiva articula pesquisa e saúde mental na busca por modos clínicos e pesquisantes mais autônomos, singulares e produzidos em conjunto no campo. (AU)

This article is an experience report of a participatory intervention and cartographic research on mental health within primary care. It problematises modes of knowledge acquisition and explores potentials and affects awakened during fieldwork. We examine the research process of the "Appraisal of Mental Health Care in Primary Health Care: An analysis of Macro-Metropolitan Region 10/Rio Grande do Sul, in light of team practices in the National Program for the Improvement of Access and Quality in Primary Care (PMAQ-AB)" and specifically discuss one city's approach. We engage the field of mental health by decentralising academic gestures in the encounter with the uncentering of basic care. Together with end-users, workers and administrators, we experimented with compositions at this level, as the entrance portal to the healthcare system, opening up to the unpredictable which requires invention and construction of a common in the midst of communities and territories. This perspective articulates research and mental care in the search for clinical practices and modes of research that are more autonomous, singular and produced jointly with the fieldwork. (AU)

En este artículo, pretendemos relatar la experiencia de una investigación participativa, interventiva y cartográfica en salud mental en atención primaria, problematizando los modos de conocer y explotando las potencialidades y afectos despertados en el campo investigativo. Traemos la trayectoria de la investigación "Calificación de la Salud Mental en Atención Primaria: el análisis de prácticas de equipos en la Región 10-Macrometropolitana/RS a partir del Programa Nacional para Mejoramiento del Acceso y Calidad de Atención Primaria (PMAQ-AB)" analizando específicamente el proceso en uno de los municipios participantes. Entramos en campo, descentralizando gestos académicos al entrar en contacto con los descentramientos de la atención primaria. Experimentamos composiciones en ese nivel de atención que es puerta de entrada del sistema de salud, junto a usuarios, trabajadores y administradores, abriéndonos a los imprevisibles que requieren invención y construcción de un común en medio de las comunidades y territorios. Esta perspectiva articula investigación y salud mental en la búsqueda de modos clínicos y investigativos más autónomos, singulares y producidos en conjunto en el campo. (AU)

New Regenerative Vascular Grafts for Hemodialysis Access: Evaluation of a Preclinical Animal Model.

The purpose of this study was to evaluate a suitable animal model for the in vivo evaluation of patency and vascular tissue regeneration in small intestinal submucosa (SIS) vascular grafts for hemodialysis access. First, a 4-mm U-shaped SIS vascular graft was implanted between the internal carotid artery (CA) and the external jugular vein (JV) in five sheep and six swine. The U-shape grafts remained functional for 53 ± 4 days in sheep and 32 ± 2 days in swine. The sheep model presented exaggerated inflammation, so the swine model was selected for the in vivo study. Based on these initial results, a 4-mm C-shape SIS vascular graft with SIS circumferential reinforcement was developed to mechanically improve the vascular graft and manage complications identified during surgery in both sheep and swine. The C-shape vascular graft was implanted in a swine model (n = 3) between the CA and JV. GORE-TEX® vascular grafts were used as controls in the contralateral side of the neck. C-shape grafts remained patent for 47 ± 4 days, whereas the GORE-TEX® grafts were patent for 30 ± 15 days. The C-shape vascular graft was easier to handle during surgery, and its circumferential reinforcement improved in vivo patency, avoiding kinks in the graft after implantation. Histological results showed neovascularization and some regeneration with the alignment of endothelial cells in the vascular wall of the grafts. The model developed may be helpful in other research involving in vivo studies of vascular grafts for hemodialysis access.

Ankyrin repeats as a dimerization module.

Legionella pneumophila is a pathogen, causing severe pneumonia in humans called Legionnaires' disease. AnkC (LegA12) is a poorly characterized 495-residue effector protein conserved in multiple Legionella species. Here, we report the crystal structure of a C-terminally truncated AnkC (2-384) at 3.2 Å resolution. The structure shows seven ankyrin repeats (ARs) with unique structural features. AnkC forms a dimer along the outer surface of loops between ARs. The dimer exists both in the crystal form and in solution, as shown by analytical ultracentrifugation. This is the first example of ARs as a dimerization module as opposed to solely a protein interaction domain. In addition, a novel α-helix insert between AR3-AR4 is positioned across the surface opposite the ankyrin groove. Sequence conservation suggests that the ankyrin groove of AnkC is a functional site that interacts with binding targets. This ankyrin domain structure is an important step towards a functional characterization of AnkC.

Mapping the ER Interactome: The P Domains of Calnexin and Calreticulin as Plurivalent Adapters for Foldases and Chaperones.

The lectin chaperones calreticulin (CRT) and calnexin (CNX) contribute to the folding of glycoproteins in the ER by recruiting foldases such as the protein disulfide isomerase ERp57 and the peptidyl prolyl cis-trans isomerase CypB. Recently, CRT was shown to interact with the chaperone ERp29. Here, we show that ERp29 directly binds to the P domain of CNX. Crystal structures of the D domain of ERp29 in complex with the P domains from CRT and calmegin, a tissue-specific CNX homolog, reveal a commonality in the mechanism of binding whereby the tip of the P domain functions as a plurivalent adapter to bind a variety of folding factors. We show that mutation of a single residue, D348 in CNX, abrogates binding to ERp29 as well as ERp57 and CypB. The structural diversity of the accessory factors suggests that these chaperones became specialized for glycoprotein folding through convergent evolution of their P-domain binding sites.

Crystal structure of the UBR-box from UBR6/FBXO11 reveals domain swapping mediated by zinc binding.

The UBR-box is a 70-residue zinc finger domain present in the UBR family of E3 ubiquitin ligases that directly binds N-terminal degradation signals in substrate proteins. UBR6, also called FBXO11, is an UBR-box containing E3 ubiquitin ligase that does not bind N-terminal signals. Here, we present the crystal structure of the UBR-box domain from human UBR6. The dimeric crystal structure reveals a unique form of domain swapping mediated by zinc coordination, where three independent protein chains come together to regenerate the topology of the monomeric UBR-box fold. Analysis of the structure suggests that the absence of N-terminal residue binding arises from the lack of an amino acid binding pocket.

Bound Waters Mediate Binding of Diverse Substrates to a Ubiquitin Ligase.

The N-end rule pathway controls the half-life of proteins based on their N-terminal residue. Positively charged type 1 N-degrons are recognized by a negatively charged pocket on the Zn finger named the UBR box. Here, we show that the UBR box is rigid, but bound water molecules in the pocket provide the structural plasticity required to bind different positively charged amino acids. Ultra-high-resolution crystal structures of arginine, histidine, and methylated arginine reveal that water molecules mediate the binding of N-degron peptides. Using a high-throughput binding assay and isothermal titration calorimetry, we demonstrate that the UBR box is able to bind methylated arginine and lysine peptides with high affinity and measure the preference for hydrophobic residues in the second position in the N-degron peptide. Finally, we show that the V122L mutation present in Johanson-Blizzard syndrome patients changes the specificity for the second position due to occlusion of the secondary pocket.

Premature separation of the placenta in an asinine female (Equus asinus) and Neonatal Maladjustment Syndrome: a case report¤ / Separación prematura de placenta en una hembra asnal (Equus asinus) y síndrome de mal ajuste neonatal: reporte de caso / Separação prematura de placenta em uma fêmea asnal (Equusasinus) e síndrome de ajuste defeituoso neonatal: relato de caso

An Equus asinus female in advanced gestation state was atended in the field, and by clinical examination manifested signs of discomfort, lateral trunk movements, postration, turning, dyspnea, rythmic abdominal movements, edematous vulva and serosanguinous secretion. The animal initiated labor, evidencing "red bag" (premature chorioallantoic separation), and obstetric manuevers were required to allow the birth of the foal, who presented signs of immaturity such as: fallen ears, soft hoves, absence of sucking reflex, postration and hypothermia. Premature separation of the placenta is diagnosed and neonatal maladjustment syndrome in the foal. The presentation of placenta previa and the onset of labor, has a direct relation with the posible neonatal maladjustment syndrome. The present case is described due to the low frequency of presentation in the Equus asinus species, in creole donkeys and as the first case described in this species in Colombia.

Una hembra Equus asinus en estado de gestación avanzada fue atendida en campo, la cual en el examen clínico manifestó signos de disconfort, movimientos laterales de tronco, postración, giros, disnea, movimientos abdominales rítmicos, vulva edematizada y secreción serosanguinolenta. El animal inició trabajo de parto evidenciando bolsa roja y se realizó maniobras obstétricas que permiten el nacimiento del borrico, el cual presentó signos de inmadurez como: orejas caídas, cascos blandos, ausencia de reflejo de succión, postración e hipotermia. Se diagnóstica separación prematura de placenta y síndrome de mal ajuste neonatal en el borrico. La presentación de placenta previa y el desencadenamiento del parto, tiene una relación directa con el posible síndrome de mal ajuste neonatal. Se describe el presente caso por su baja frecuencia en la especie Equus asinus, en asnos criollos y como primer caso descrito en la especie en Colombia.

Uma fêmea Equus asinus em estado de gestação avançada foi atendida em campo, a qual no exame clínico manifestou signos de desconforto, movimentos laterais de tronco, prostração, giros, disnea, movimentos abdominais rítmicos, vulva edemaciada e secreção sorosanguinolenta. O animal iniciou trabalho de parto evidenciando-se um saco vermelho e após se realizou manobras obstétricas que permitem o nascimento do burrico, o qual apresentou signos de imaturidade como: orelhas caídas, cascos moles, ausência do reflexo de sucção, prostração e hipotermia. Se diagnostica separação prematura de placenta e síndrome de ajuste defeituoso neonatal no burrico. A apresentação de placenta previa e o desencadeamento do parto, tem uma relação direta com a possível síndrome de ajuste defeituoso neonatal. Descreve-se este relato de caso por sua baixa frequência na espécie Equus asinus em jumentos crioulos e como o primeiro relato de caso descrito nesta espécie na Colômbia.

The MLLE domain of the ubiquitin ligase UBR5 binds to its catalytic domain to regulate substrate binding.

E3 ubiquitin ligases catalyze the transfer of ubiquitin from an E2-conjugating enzyme to a substrate. UBR5, homologous to the E6AP C terminus (HECT)-type E3 ligase, mediates the ubiquitination of proteins involved in translation regulation, DNA damage response, and gluconeogenesis. In addition, UBR5 functions in a ligase-independent manner by prompting protein/protein interactions without ubiquitination of the binding partner. Despite recent functional studies, the mechanisms involved in substrate recognition and selective ubiquitination of its binding partners remain elusive. The C terminus of UBR5 harbors the HECT catalytic domain and an adjacent MLLE domain. MLLE domains mediate protein/protein interactions through the binding of a conserved peptide motif, termed PAM2. Here, we characterize the binding properties of the UBR5 MLLE domain to PAM2 peptides from Paip1 and GW182. The crystal structure with a Paip1 PAM2 peptide reveals the network of hydrophobic and ionic interactions that drive binding. In addition, we identify a novel interaction of the MLLE domain with the adjacent HECT domain mediated by a PAM2-like sequence. Our results confirm the role of the MLLE domain of UBR5 in substrate recruitment and suggest a potential role in regulating UBR5 ligase activity.

Saúde mental e vulnerabilidade social: o cuidado na atenção básica

O objetivo desta escrita é analisar o cuidado em saúde mental na atenção básica em uma comunidade em situação de vulnerabilidade social, a fim de conhecer e potencializar ações e estratégias de cuidado neste contexto. A atenção básica lida cotidianamente com situações que envolvem sofrimento psíquico e o Ministério da Saúde vem estimulando ações que remetem à dimensão subjetiva dos usuários. A proximidade do posto de saúde com os territórios coloca em questão como trabalhar em contextos de vulnerabilidade, sendo importante pensar e construir novas práticas de cuidado. Os profissionais de saúde se lidam com a produção cuidado em saúde mental diante de tantas dificuldades de vida das pessoas/vulnerabilidades que parecem colocar outras necessidades anteriores, como a violência. Ou o que pode o trabalhador da saúde neste contexto, em que a violência, a falta de saneamento básico ou de alimentação se impõe? Ou como cuidar da vida das pessoas em contextos de sobrevida? Embora atualmente se considere a importância dos fatores sociais na saúde, sabe-se que tal construção é recente na história e as produções sobre as tecnologias leves de cuidado necessitam avançar neste aspecto. Tal questão de pesquisa se torna pertinente pela importância da vulnerabilidade social nas questões de saúde e pela forma diferenciada que o olhar, a escuta e a atuação do trabalhador da saúde se fazem neste contexto. O método utilizado neste trabalho é a cartografia, que busca acompanhar o processo do campo de pesquisa, destacando a importância da prática, de experimentar dispositivos, habitar um território, deslocar pontos de vista e praticar a escrita. Foram realizadas rodas de conversa e usado o diário de campo como dispositivos para operar a cartografia. Buscamos nesta escrita contribuir para reflexão e construção de conhecimento sobre o cuidado em saúde mental em comunidades em situação de vulnerabilidade social no contexto da Atenção Básica em Saúde, no âmbito da saúde mental

Relación entre tipo y cantidad de carbohidratos dietarios con el perfil lipídico y ApoB100 en adultos / Relationship between the type and quantity of dietary carbohydrates, and the lipid profile and ApoB100 in adults / Relação entre o tipo e a quantidade de carboidratos na dieta e o perfil lipídico e ApoB100 em adultos

Objetivo. Establecer si existe relación entre el tipo y la cantidad de carbohidratos dietarios consumidos habitualmente con los niveles plasmáticos de lípidos, lipoproteínas y apolipoproteína B100 (ApoB100) Materiales y métodos. La muestra estuvo conformada por la base de datos de 144 de profesores de la Universidad Javeriana que previamente hicieron parte de otra investigación y de la cual se empleo la información sobre su alimentación, niveles plasmáticos de lípidos, lipoproteínas y ApoB100. Para determinar la relación entre las variables dependientes e independientes se realizó análisis de correlación simple y múltiple, en los casos de no correlación, se aplicó la prueba Chi² de independencia para relacionar el consumo de carbohidratos totales, azúcares y fibra total. Adicionalmente el análisis de varianza de un factor comparó los niveles de lípidos, lipoproteínas y ApoB100 con el consumo de carbohidratos totales, azúcares y fibra. Resultados. 76 hombres y 68 mujeres. La mayor parte de la población consume por encima de la recomendación diaria de carbohidratos totales, los hombres presentaron mayor consumo de carbohidratos tipo azúcares y más elevados los niveles plasmáticos de triglicéridos y lipoproteínas de muy baja densidad (VLDL), mientras que mujeres presentaron niveles más elevados en sus lipoproteínas de alta densidad (HDL). Al relacionar gramos de cada tipo de carbohidratos, con los niveles de lípidos, lipoproteínas y ApoB100 no se encontró correlación significativa para ninguno de los casos (p>0,05). Conclusión. No se encontró relación significativa entre el tipo y la cantidad de carbohidratos consumidos con los niveles plasmáticos de lípidos, lipoproteínas y ApoB100.

Objective. To establish if there is any relationship between the type and amount of dietary carbohydrates commonly consumed and the plasmatic levels of lipids, lipoproteins and apolipoprotein B100 (ApoB100). Materials and methods. The final sample was conformed by the database of 144 lecturers of the Pontificia Universidad Javeriana who had previously participated in another survey and from which we used information on their food habits, plasmatic lipid levels, lipoproteins and ApoB100. To determine the relationship between the dependent and independent variables, simple and multiple correlation analyses were done. In the cases of no correlation we applied the independence Chi² test to find the relationship with the consumption of total carbohydrates, sugars and total fiber. Additionally, with a one-factor analysis of variance we compared plasmatic levels of lipids, lipoproteins and ApoB100 with the consumption of total carbohydrates, sugars and fiber. Results. Most of the population consumes above the daily total carbohydrate recommendation, men presented greater carbohydrate consumption of the type of sugars and more elevated plasmatic levels of triglycerides and lipoproteins of investivery low density (VLDL), whereas women presented higher levels of their high density lipoproteins (HDL). When relating grams of each type of carbohydrates with the levels of lipids, lipoproteins and ApoB100, no significant correlation was found for any of the cases (p>0,05). Conclusion. There was no significant relationship between the type and amount of carbohydrates consumed with the plasmatic levels of lipids, lipoproteins and Apo B100.

Objetivo. Estabelecer a possível relação entre o tipo e a quantidade de carboidratos na dieta normalmente consumida com os níveis plasmáticos de lipídios, lipoproteínas e apolipoproteína B100 (ApoB100). Materiais e métodos. A amostra consistiu de um banco de dados de 144 professores da "Universidad Javeriana" que anteriormente fizeram parte de outra pesquisa, e da qual foi utilizada a informação sobre sua alimentação, os níveis plasmáticos de lipídios, lipoproteínas e ApoB100. Para determinar a relação entre as variáveis dependentes e independentes foi realizada uma análise de correlação simples e múltipla, em casos de ausência de correlação foi usado o teste do Chi² de independência para relacionar o consumo dos carboidratos totais, açúcares e fibra total. Além disso, a análise de variância de um fator comparou os níveis de lipídios, lipoproteínas e ApoB100 com o consumo de carboidratos totais, açúcares e fibras. Resultados. 76 homens e 68 mulheres. A maior parte da população consome acima da dose diária recomendada de carboidratos totais, os homens apresentaram maior consumo de carboidratos tipo açúcares, e mais elevados os níveis plasmáticos de triglicérides e lipoproteínas de muito baixa densidade (VLDL), enquanto que as mulheres apresentaram níveis mais elevados em lipoproteína de alta densidade (HDL). Ao relacionar gramas de cada tipo de carboidratos com os níveis de lipídios, lipoproteínas e ApoB100, nenhuma correlação significativa foi encontrada para qualquer um dos casos (p> 0,05). Conclusão. Nenhuma relação significativa foi encontrada entre o tipo e a quantidade de carboidratos consumida com os níveis plasmáticos de lipídios, lipoproteínas e ApoB100.