Relapse rate and renal prognosis in ANCA-associated vasculitis according to long-term ANCA patterns.

Long-term observation of patients with ANCA-associated vasculitis (AAV) allows the identification of different longitudinal patterns of ANCA levels during follow-up. This study aimed to characterize these patterns and to determine their prognostic significance. All ANCA determinations performed in two university hospitals during a 2-year period were retrospectively reviewed. Patients were included in the analysis if they had high titers of anti-myeloperoxidase (anti-MPO) or anti-proteinase 3 (anti-PR3) antibodies at least once, ≥ 5 serial ANCA determinations and AAV diagnosed by biopsy or American College of Rheumatology (ACR) classification criteria. Patients' time-course ANCA patterns were classified as monophasic, remitting, recurrent or persistent. Associations between ANCA patterns and prognostic variables (relapse rate and renal outcome) were analysed by univariate and multivariate statistics. A total of 99 patients [55 with microscopic polyangiitis (MPA), 36 with granulomatosis with polyangiitis (GPA) and eight with eosinophilic granulomatosis with polyangiitis (EGPA)] were included. Median follow-up was 9 years. Among patients diagnosed with MPA or GPA, recurrent or persistent ANCA patterns were associated with a higher risk of clinical relapse [hazard ratio (HR) = 3·7, 95% confidence interval (CI) = 1·5-9·1 and HR = 2·9, 95% CI = 1·1-8·0, respectively], independently of clinical diagnosis or ANCA specificity. In patients with anti-MPO antibodies, the recurrent ANCA pattern was associated with worsening renal function [odds ratio (OR) = 5·7, 95% CI = 1·2-26·0]. Recurrent or persistent ANCA patterns are associated with a higher risk of clinical relapse. A recurrent ANCA pattern was associated with worsening renal function in anti-MPO-associated vasculitis.

Global CO2 emissions from dry inland waters share common drivers across ecosystems.

Many inland waters exhibit complete or partial desiccation, or have vanished due to global change, exposing sediments to the atmosphere. Yet, data on carbon dioxide (CO2) emissions from these sediments are too scarce to upscale emissions for global estimates or to understand their fundamental drivers. Here, we present the results of a global survey covering 196 dry inland waters across diverse ecosystem types and climate zones. We show that their CO2 emissions share fundamental drivers and constitute a substantial fraction of the carbon cycled by inland waters. CO2 emissions were consistent across ecosystem types and climate zones, with local characteristics explaining much of the variability. Accounting for such emissions increases global estimates of carbon emissions from inland waters by 6% (~0.12 Pg C y-1). Our results indicate that emissions from dry inland waters represent a significant and likely increasing component of the inland waters carbon cycle.

Accuracy of transcutaneous bilirubin on covered skin in preterm and term newborns receiving phototherapy using a JM-105 bilirubinometer.

OBJECTIVE: Determine the suitability of transcutaneous bilirubin (TCB) as a tool to assess the effectiveness of phototherapy on patched skin. STUDY DESIGN: A prospective observational study was conducted. We covered a fragment of skin (sternum) with a photo-opaque patch. Several simultaneous TCB and TSB measurements were performed with the JM-105 bilirubinometer. Bland and Altman test evaluated the agreement between bilirubin levels. RESULT: A total of 217 patients were studied, 48.8% were preterm. The mean difference between TSB and TCB before the start of treatment was 1.07 mg/dL. During phototherapy, differences on covered skin were 0.52, 0.27, and 0.39 mg/dL at 24, 48, and 72 h of therapy respectively. The best correlation was observed at 48 h in preterm infants. CONCLUSION: The measurement of TCB on patched skin (PTCB) is useful for monitoring the response to phototherapy in term and preterm infants. We use a patch with a removable flap that eases successive measures without disturbing the patients.

Anti-inflammatory effects of aloe vera on soy meal-induced intestinal inflammation in zebrafish.

Soybean meal is one of the most promising alternatives to replace fishmeal in the aquaculture industry. However, its ingestion triggers an intestinal inflammatory process that compromises fish health and nutrition. Therefore, finding strategies that reduce the deleterious effects of a soy protein-based diet are relevant. In this work we analyzed the effects of an aloe vera (Aloe barbadensis miller, AV) extract on intestinal inflammation and innate immunity of zebrafish by adding it to the water and by supplementing it in a soybean meal-based diet. To search for potential immunomodulatory effects of AV, we tested its effectiveness in two inflammation assays and compared fish fed with either fishmeal or soybean meal-based feed supplemented with AV. Our results show a strong anti-inflammatory effect of AV. Furthermore, while soy-based meal strongly induces the expression of inflammation markers, supplementation with AV reverted this effect. Finally, we show that fish fed with a soy meal diet are highly susceptible to bacterial infection, but that this condition is significantly reduced when the soy meal is supplemented with AV. Our results suggest that AV is a good candidate to be incorporated as an additive in farmed fish diets to facilitate the replacement of fishmeal by soybean meal, maintaining intestinal health.

Epidemiología lesional en actividades escolares y extraescolares en la Comunidad de Madrid (España) / Sport Injuries in School and Extracurricular Activities in the Community of Madrid (Spain)

Este estudio tuvo como objetivo analizar la epidemiología lesional deportiva de las actividades desarrolladas bajo responsabilidad docente (Educación Física, recreo y actividades extraescolares) en centros de Educación Secundaria Obligatoria (ESO). Participaron 1.050 estudiantes (edad media 13,9 ± 1,3 años) que cumplimentaron un cuestionario sobre lesiones deportivas. De las 848 lesiones registradas en total, 319 (172 en chicos y 147 en chicas) ocurrieron en actividades desarrolladas bajo responsabilidad docente (0,30 lesiones/estudiante). Las actividades extraescolares fueron el ámbito con mayor promedio de lesiones (0,12 por estudiante). Se observó una mayor incidencia lesional a los 13 años y una menor probabilidad de que las lesiones ocurriesen en los chicos (OR = 0,64 (0,49-0,85); p < 0,05). Los esguinces y las contusiones fueron las lesiones más frecuentes, especialmente en tobillo y rodilla. Un 27,3% de las lesiones impidieron al alumnado participar activamente en las sesiones de Educación Física durante más de tres días

This study aimed to analyse the epidemiology of sport injuries that occurred during activities performed under teacher supervision (Physical Education, break and extracurricular activities), at high school. A questionnaire regarding sport injuries were administered to 1050 students (mean age 13.9 ± 1.3 years). Out of the 848 sport injuries registered, 319 (172 in boys and 147 in girls) took place during activities performed under teacher supervision, (0.30 injuries/student). Extracurricular activities were the scenario in which the highest injury rate (0.12) was observed. There was a higher incidence of injury at age 13 and a lower likelihood of injuries occurring in boys (OR = 0.64 (0.49-0.85); p < 0.05). Sprains and contusions were the type of injury most frequently observed, especially in areas such as ankles and knees. A total of 27.3% of the injuries reported prevented the students from actively participating in the Physical Education sessions for more than three days

Prenatal Therapy with Magnesium Sulfate and Its Correlation with Neonatal Serum Magnesium Concentration.

INTRODUCTION: Antenatal magnesium sulfate (MgSO4) administration has shown to be effective in minimizing cerebral palsy and severe motor dysfunction at the age of 2 years. The aim of this study is to determine the relationship between the magnesium dose delivered to the mother and the magnesium concentration in the neonates. MATERIALS AND METHODS: A prospective cohort study was conducted on neonates of less than 32 weeks' gestation admitted to the neonatal intensive care unit of University Hospital Complex of Vigo from December 2012 to July 2015. Comparative analysis of magnesium levels between the groups of neonates exposed to MgSO4 and the control group. RESULTS: A total of 118 neonates were included in the study. The mothers of 62 of them had received MgSO4 as a neuroprotective agent. There was a significant correlation between the full dose of MgSO4 received by the mother and the levels of magnesium in the neonate in the first 24 hours of life (r2 = 0.397; p < 0.001). CONCLUSION: The MgSO4 dose received by the mother has a linear relationship with the magnesium levels obtained in neonates.

PCR protocol for detection of Vibrio ordalii by amplification of the vohB (hemolysin) gene.

Vibrio ordalii is the causative agent of atypical vibriosis and has the potential to cause severe losses in salmonid aquaculture. To prevent and control outbreaks, a rapid, reproducible, sensitive, and effective diagnostic method is needed. We evaluated a new conventional polymerase chain reaction (PCR) and real-time PCR (qPCR) protocol using a primer set (VohB_Fw-VohB_Rv) designed to amplify a 112 bp fragment flanking the vohB gene (coding for hemolysin production), against 24 V. ordalii strains isolated from different fish species, the V. ordalii type strain, and 42 representative related and unrelated bacterial species. The primer set was species-specific, recognizing all V. ordalii strains evaluated, with no cross-reaction with the other bacterial species. A sensitivity of 103 copies of the vohB gene was obtained with a standard curve. When the VohB_Fw-VohB_Rv qPCR protocol was applied to Atlantic salmon seeded tissues (kidney, liver, spleen, and muscle), the detection limit ranged from 5.27 × 102 to 4.13 × 103 V. ordalii CFU ml-1, i.e. 62 to 145 copies of the vohB gene, using the previously calculated standard curve. The conventional PCR also detected V. ordalii, but the total reaction time was 1 h longer. When the qPCR protocol was applied to naturally infected cage-cultured Atlantic salmon samples, 5 of 8 fish tested positive for V. ordalii, but only one of them was diagnosed as positive by direct cultivation on agar. We conclude that the PCR protocol evaluated is fast, specific, and sensitive enough to detect V. ordalii in infected tissues and is an important tool for secure diagnosis of atypical vibriosis, and is therefore helpful for the control of the disease through the prompt detection within fish populations.

Calidad de la prescripción antibiótica en un servicio de urgencias pediátrico hospitalario / Antibiotic prescribing in a paediatric emergency department

Introducción: Una política antibiótica correcta en los servicios de urgencias pediátricos es esencial dado el alto número de consultas por patología infecciosa. El objetivo es conocer la adecuación del tratamiento antibiótico prescrito a los niños atendidos en un servicio de urgencias pediátrico. Material y métodos: Revisión retrospectiva de los informes de alta de niños atendidos en el servicio de urgencias pediátrico por otitis media aguda, faringoamigdalitis aguda o neumonía adquirida en la comunidad durante el 2008. Se seleccionó una muestra aleatoria de 100 casos para cada patología. La adecuación del antibiótico se valoró para los siguientes aspectos: enfermedad subsidiaria de tratamiento antibiótico, elección de antibiótico adecuado, dosis, intervalo y duración del mismo. Una actitud errónea en cualquier parámetro se consideró prescripción inadecuada. La valoración de la adecuación se realizó acorde a los protocolos existentes en urgencias. Resultados: Se prescribió antibiótico a 219 pacientes (73%). La prescripción antibiótica fue inadecuada en 67 niños (22,3%). Se pautó antibiótico innecesariamente a 15 (6,8%) y en 4 (2%) la selección del mismo fue incorrecta. A un niño (1,2%) no se pautó antibiótico cuando estaba indicado. La duración del tratamiento fue incorrecta en 22 casos (11,5%), todos por una menor duración, el intervalo en 20 (10,1%), y la dosis en 13 (6,5%). Conclusiones: En las patologías estudiadas existió un uso adecuado de antibiótico, con unas tasas de adecuación altas para la decisión de tratar y la elección del antibiótico. La duración incorrecta del tratamiento fue el principal motivo de prescripción inadecuada. Es necesario adoptar medidas para la corrección de los aspectos más deficitarios detectados (AU)

Introduction: Adequate antibiotic prescribing in Paediatric Emergency Departments (PEDs) is a necessity due to the high number of patients consulting for infectious diseases. The aim of this study was to evaluate the antibiotic prescription quality in a PED. Material and methods: Retrospective study of patients attending a PED and diagnosed with acute otitis media, pharyngotonsillitis or community-acquired pneumonia during 2008. A random sample of 100 cases for each disease was selected. The parameters employed for assessing the prescribing quality were: illness subject to being treated with antibiotics, adequate antibiotic, dosage, interval of administration and length of treatment. An error in any of these parameters was considered an inappropriate prescription. The appropriateness of the antibiotic prescriptions was assessed based on the recommendations described on our hospital protocols. Results: Antibiotics were prescribed to 219 patients (73%). Therapy was considered to be inappropriate in 67 children (22.3%). Unnecessary treatment was indicated in 15 cases (6.8%) and in 4 patients (2%) the antibiotic selected was incorrect. Antibiotic was not prescribed to one patient subject to being treated (1.2%). The treatment length was wrong in 22 cases (11.5%), inappropriately short in all of them, the interval of administration in 20 (10.1%) and dosage in 13 (6.5%). Conclusions: The use of antibiotics was appropriate for the diseases analysed, particularly as regards to the indication and antibiotic selection. The length of the treatment was the aspect found to be most deficient. Some important measures should be undertaken in order to improve antibiotic prescription quality (AU)

[Antibiotic prescribing in a paediatric emergency department]. / Calidad de la prescripción antibiótica en un servicio de urgencias pediátrico hospitalario.

INTRODUCTION: Adequate antibiotic prescribing in Paediatric Emergency Departments (PEDs) is a necessity due to the high number of patients consulting for infectious diseases. The aim of this study was to evaluate the antibiotic prescription quality in a PED. MATERIAL AND METHODS: Retrospective study of patients attending a PED and diagnosed with acute otitis media, pharyngotonsillitis or community-acquired pneumonia during 2008. A random sample of 100 cases for each disease was selected. The parameters employed for assessing the prescribing quality were: illness subject to being treated with antibiotics, adequate antibiotic, dosage, interval of administration and length of treatment. An error in any of these parameters was considered an inappropriate prescription. The appropriateness of the antibiotic prescriptions was assessed based on the recommendations described on our hospital protocols. RESULTS: Antibiotics were prescribed to 219 patients (73%). Therapy was considered to be inappropriate in 67 children (22.3%). Unnecessary treatment was indicated in 15 cases (6.8%) and in 4 patients (2%) the antibiotic selected was incorrect. Antibiotic was not prescribed to one patient subject to being treated (1.2%). The treatment length was wrong in 22 cases (11.5%), inappropriately short in all of them, the interval of administration in 20 (10.1%) and dosage in 13 (6.5%). CONCLUSIONS: The use of antibiotics was appropriate for the diseases analysed, particularly as regards to the indication and antibiotic selection. The length of the treatment was the aspect found to be most deficient. Some important measures should be undertaken in order to improve antibiotic prescription quality.

Are multiple checkpoint mediators involved in a checkpoint linking histone gene expression with DNA replication?

In metazoans, accurate replication of chromosomes is ensured by the coupling of DNA synthesis to the synthesis of histone proteins. Expression of replication-dependent histone genes is restricted to S-phase by a combination of cell cycle-regulated transcriptional and post-transcriptional control mechanisms and is linked to DNA replication by a poorly understood mechanism involving checkpoint kinases [Su, Gao, Schneider, Helt, Weiss, O'Reilly, Bohmann and Zhao (2004) EMBO J. 23, 1133-1143; Kaygun and Marzluff (2005) Nat. Struct. Mol. Biol. 12, 794-800]. Here we propose a model for the molecular mechanisms that link these two important processes within S-phase, and propose roles for multiple checkpoints in this mechanism.

Producción de enzimas ligninolíticas con hongos basidiomicetos cultivados sobre materiales lignocelulósicos / Production of ligninolytic enzimes from basidiomycete fungi on lignocellulosic materials

Los hongos de podredumbre blanca de la madera tienen la capacidad de producir un complejo enzimático con actividad oxidativa contra una amplia variedad de sustancias tóxicas recalcitrantes como plaguicidas, tintes, hidrocarburos poliaromáticos, explosivos, etc., que contaminan suelos y cuerpos de agua. Su propagación sobre suelos contaminados, la producción de enzimas ligninolíticas y la biodegradación de contamimantes, se favorece cuando estos hongos se inoculan en el suelo mezclados con materiales lignocelulósicos que les suministran la fuente de carbono necesaria para sotener su crecimiento e inducir la producción del complejo enzimático. Este trabajo muestra la capacidad para producir las enzimas ligninolíticas manganeso peroxidasa (MnP) y lignino peroxidasa (LiP) en cultivos de los hongos Bjerkandera adusta y Phanerochaete chrysporium sobre tres materiales lignocelulósicos: viruta de madera, carozo de maíz y compost de jardinería. De estos materiales, la viruta de madera permitió alcanzar los mayores títulos de la enzima MnP, con valores de 5.0 U/g de material seco cuando se cultiva con Bj. adusta y de 1.3 U/g de material seco con P. chrysosporium, mientras que con carozo de maís se obtienen las mejores actividades de LiP. Estos materiales se mostraron adecuados para favorecer la producción de enzimas ligninolíticas y para ser empleados como soportes en la inoculación de hongos sobre suelos contaminados

Activation of mammalian Chk1 during DNA replication arrest: a role for Chk1 in the intra-S phase checkpoint monitoring replication origin firing.

Checkpoints maintain order and fidelity in the cell cycle by blocking late-occurring events when earlier events are improperly executed. Here we describe evidence for the participation of Chk1 in an intra-S phase checkpoint in mammalian cells. We show that both Chk1 and Chk2 are phosphorylated and activated in a caffeine-sensitive signaling pathway during S phase, but only in response to replication blocks, not during normal S phase progression. Replication block-induced activation of Chk1 and Chk2 occurs normally in ataxia telangiectasia (AT) cells, which are deficient in the S phase response to ionizing radiation (IR). Resumption of synthesis after removal of replication blocks correlates with the inactivation of Chk1 but not Chk2. Using a selective small molecule inhibitor, cells lacking Chk1 function show a progressive change in the global pattern of replication origin firing in the absence of any DNA replication. Thus, Chk1 is apparently necessary for an intra-S phase checkpoint, ensuring that activation of late replication origins is blocked and arrested replication fork integrity is maintained when DNA synthesis is inhibited.

Sialic acid levels in serum and tissue from colorectal cancer patients.

Sialic acid levels were determined in serum and in both normal and tumour-derived tissues from 30 patients with colorectal cancer. Total sialic acid (TSA), bound sialic acid (BSA),TSA normalised to total protein (TSA/TP) and BSA normalised to total protein (BSA/TP) were significantly higher (P < 0.0001) in sera from patients than in normal subjects. We found a trend of increasing serum sialic acid levels (TSA/TP and BSA/TP) as the malignancy became more severe (i.e. Dukes' stages A to C). Comparison of sialic acid levels between normal and tumour-derived colorectal tissues indicated no statistically significant differences in TSA, BSA or FSA (free sialic acid) levels between both tissues; however, TSA/TP and BSA/TP values were significantly decreased (P < 0.05) in the tumoral tissue. In this study, the possible relation between serum and tumour sialic acid levels in colorectal cancer patients was investigated. Our results showed that in these patients there was no correlation between serum BSA and tumour BSA levels.

Human colon sialidase: characterization and activity levels in normal mucosa and colonic adenocarcinoma.

Human colon sialidase has been characterized, and its activity levels in normal mucosa and colonic adenocarcinoma have been determined. Sialidase activity was maximal at pH 5.5, and was unstable with storage at 4 and -20 degrees C. The bulk of activity was pellet-associated, and could not be released with triton X-100 or 3-([3-cholamidopropyl]- dimethylammonio)-1-propanesulfonate. Using 2'-(4-methylumbelliferyl)alpha-D-N-acetylneuraminic acid as substrate, the Km and Vmax values were estimated to be 0.140 mmol/l and 63 mU/g, respectively. Furthermore, an inhibition by substrate concentrations above 1.5 mmol/l was detected. Neuraminic acid caused a competitive inhibition with a Ki of 3.5 mmol/l. A statistically significant increase (p < 0.001) in the sialidase specific activity was found in primary colonic adenocarcinoma (104.20 +/- 8.00 mU/g) compared to that of the normal mucosa (72.50 +/- 7.67 mU/g).